Individual
JESSICA LYNNE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
301 VICTORIA ST, COSTA MESA, CA 92627-1995
(949) 642-2734
Mailing address
301 VICTORIA ST, COSTA MESA, CA 92627-1995
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
254944
CA
Other
Enumeration date
12/31/2019
Last updated
12/31/2019
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