Individual
JOURNEY BLUE BACA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
3686 PACIFIC AVE, JURUPA VALLEY, CA 92509-1948
(888) 700-5053
Mailing address
850 N BENSON AVE # A82, UPLAND, CA 91786-3551
(909) 539-7038
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
728922
CA
Other
Enumeration date
06/23/2025
Last updated
06/23/2025
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