Individual
KATIE ELLEN JACQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
601 5TH AVE, UPLAND, CA 91786-4839
(909) 949-6526
Mailing address
12791 REED AVE, GRAND TERRACE, CA 92313-6029
(909) 648-5407
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
—
—
Other
Enumeration date
08/26/2025
Last updated
08/26/2025
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