Individual
JASPER SHIRLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1664 BROADWAY, EL CAJON, CA 92021-5201
(619) 579-8685
Mailing address
1664 BROADWAY, EL CAJON, CA 92021-5201
(619) 579-8685
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
225400000X
Rehabilitation Practitioner
—
—
Other
Enumeration date
05/28/2025
Last updated
06/06/2025
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