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Individual

MISS JULISSA AMINA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.M.T.

Contact information

Practice address
1601 KETTNER BLVD UNIT 11, SAN DIEGO, CA 92101-2539
(808) 938-2505
Mailing address
1948 1ST AVE APT 4, SAN DIEGO, CA 92101-2336
(808) 938-2505

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
35126
CA
225700000X
Massage Therapist
MAT 9623
HI

Other

Enumeration date
10/23/2007
Last updated
08/26/2020
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