Individual
JAY EDWARD MITCHELL-WRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
935B SPRING ST, PLACERVILLE, CA 95667-4523
(530) 621-6210
Mailing address
935B SPRING ST, PLACERVILLE, CA 95667-4523
(530) 621-6210
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
VN 215128
CA
167G00000X
Licensed Psychiatric Technician
Primary
PT 25635
CA
Other
Enumeration date
12/11/2014
Last updated
05/20/2023
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