Individual
JENISE LAURA PAULSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
1470 MARIA LN, SUITE # 420, WALNUT CREEK, CA 94596-5343
(925) 295-4936
Mailing address
1470 MARIA LN, SUITE # 420, WALNUT CREEK, CA 94596-5343
(925) 295-4936
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT 23694
CA
Other
Enumeration date
01/03/2007
Last updated
12/30/2021
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