Individual
JORY LEISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4067 SANTA ANA AVE, CLOVIS, CA 93619-8593
(484) 798-4284
Mailing address
4067 SANTA ANA AVE, CLOVIS, CA 93619-8593
(484) 798-4284
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95098967
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
95001666
CA
Other
Enumeration date
06/29/2021
Last updated
02/01/2022
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