Individual
JACQUELINE M CARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3220 SOUTH HIGUERA STREET, SUITE 320, SAN LUIS OBISPO, CA 93401-6987
(805) 541-1790
(805) 541-1793
Mailing address
3220 SOUTH HIGUERA STREET, STE. 320, SAN LUIS OBISPO, CA 93401-6987
(805) 541-1790
(805) 541-1793
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
HA 4180
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HA 4180
DISPENSER LICENSE
CA
Enumeration date
05/07/2007
Last updated
09/20/2011
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