Individual
JESSICA BLAIR MACIAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
2865 LOGAN AVE, SAN DIEGO, CA 92113-2411
(619) 232-4357
Mailing address
231 E ORLANDO ST, CHULA VISTA, CA 91911-3617
(619) 721-7111
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN277190
CA
Other
Enumeration date
09/11/2014
Last updated
09/11/2014
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