Individual
JESSICA KYOMI AVILA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
VA LONG BEACH HCS ATTN: JESSICA AVILA GEC/CLC, MAILSTOP:08/118 5901 EAST 7TH STREET, LONG BEACH, CA 90803
(562) 706-9228
Mailing address
14084 RANCHO RD, WESTMINSTER, CA 92683-4154
(714) 514-3551
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
—
—
Other
Enumeration date
11/22/2022
Last updated
11/22/2022
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