Individual
JESSE RAY TARIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LVN
Contact information
Practice address
23155 GUINEA ST, LAKE FOREST, CA 92630-3829
(949) 922-9843
Mailing address
23155 GUINEA ST, LAKE FOREST, CA 92630-3829
(949) 922-9843
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
289991
CA
Other
Enumeration date
11/21/2020
Last updated
11/21/2020
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