Individual
MISS JENNA JILL GOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
1722 S LEWIS RD, CAMARILLO, CA 93012-8520
(805) 570-8688
Mailing address
610 SUNRISE DR, SUITE #2G, SANTA MARIA, CA 93455-2178
(805) 937-4259
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
3856
CA
Other
Enumeration date
11/06/2006
Last updated
07/08/2007
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