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Individual

MRS. MARIA CORAZON JOSE JARA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, PHN

Contact information

Practice address
1845 N FAIR OAKS AVE, PASADENA, CA 91103-1620
(626) 744-6005
(626) 744-6115
Mailing address
430 MILTON DR, SAN GABRIEL, CA 91775-2823
(626) 744-6041
(626) 744-6115

Taxonomy

Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
RN288512
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RN288512
LICENSE NUMBER
CA
Enumeration date
05/18/2007
Last updated
07/08/2007
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