Individual
JOSE JUAREZ JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
500 N 9TH ST, MODESTO, CA 95350-5814
(209) 558-4610
Mailing address
6213 EAGLE RIDGE DR, RIVERBANK, CA 95367-2609
(209) 495-6720
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
647496
CA
Other
Enumeration date
10/02/2008
Last updated
10/26/2012
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