Individual
JALEN XAVIER WESLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
166 ATHOL AVE, OAKLAND, CA 94606-1779
(205) 234-9314
Mailing address
166 ATHOL AVE APT 205, OAKLAND, CA 94606-1770
(205) 234-9314
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95030101
CA
Other
Enumeration date
05/13/2024
Last updated
05/13/2024
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