Individual
JESSE TREJO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3660 STATE HIGHWAY 132, COULTERVILLE, CA 95311-9722
(209) 566-5559
Mailing address
3660 STATE HIGHWAY 132, COULTERVILLE, CA 95311-9722
(209) 566-5559
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2095665559
VA BOWEL AND BLADDER
CA
Enumeration date
08/27/2019
Last updated
08/27/2019
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