Individual
JAYNE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1201 OAKMONT RD APT 196A, SEAL BEACH, CA 90740-3635
(310) 408-1763
Mailing address
1201 OAKMONT RD APT 196A, SEAL BEACH, CA 90740-3635
(310) 408-1763
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
95003744
CA
Other
Enumeration date
04/18/2016
Last updated
04/18/2016
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