Individual
JA'TERRA COOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
760 MOUNTAIN VIEW ST, ALTADENA, CA 91001-4925
(626) 798-6793
Mailing address
92 W TERRACE ST, ALTADENA, CA 91001-4730
(513) 818-6584
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
266500
CA
Other
Enumeration date
07/03/2015
Last updated
07/03/2015
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