Individual
TAYLOR COLETTE JARNAGIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1660 HOTEL CIR N STE 314, SAN DIEGO, CA 92108-2803
(619) 759-1548
Mailing address
1660 HOTEL CIR N STE 314, SAN DIEGO, CA 92108-2803
(619) 759-1548
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
175T00000X
—
CA
Enumeration date
01/16/2024
Last updated
12/17/2024
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