Individual
JESSICA MAGGIE MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2844 COLOMA ST, PLACERVILLE, CA 95667-4406
(530) 642-9240
Mailing address
2844 COLOMA ST, PLACERVILLE, CA 95667-4406
(530) 642-9240
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D8239239
EDUCATOR
CA
Enumeration date
04/09/2012
Last updated
04/09/2012
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