Individual
JYLLIAN NISSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
408 MAIN ST, SALINAS, CA 93901-3306
(831) 273-0124
Mailing address
764 SOLANO, SOLEDAD, CA 93960-3380
(909) 229-6589
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
52902
CA
Other
Enumeration date
12/26/2023
Last updated
12/26/2023
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