Individual
MISS JENNA MARIE GONCALVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
637 3RD AVE, CHULA VISTA, CA 91910-5707
(619) 433-5856
Mailing address
637 3RD AVE, CHULA VISTA, CA 91910-5707
(619) 433-5856
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
08/26/2011
Last updated
09/28/2023
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