Individual
JED BENEDICT ABELLA BARIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
44505 90TH ST W, LANCASTER, CA 93536-7705
(818) 996-1051
Mailing address
36748 37TH ST E, PALMDALE, CA 93550-8430
(818) 939-1580
(818) 939-1580
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-YPFSQN
CA
Other
Enumeration date
07/18/2025
Last updated
07/18/2025
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