Organization
JAIYEN SPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NINA ELLEN CONVERSE (MANAGER)
(707) 237-4495
Entity
Organization
Contact information
Practice address
868 GRAVENSTEIN HWY N, SEBASTOPOL, CA 95472-2846
(707) 861-3562
Mailing address
868 GRAVENSTEIN HWY N, SEBASTOPOL, CA 95472-2846
(707) 861-3562
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
10/31/2024
Last updated
10/31/2024
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