Individual
MISS JACQUELINE HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
4925 BERRYMAN AVE, CULVER CITY, CA 90230-5111
(323) 617-0430
Mailing address
4925 BERRYMAN AVE, CULVER CITY, CA 90230-5111
(323) 617-0430
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
83731
CA
Other
Enumeration date
12/09/2020
Last updated
12/09/2020
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