Individual
JERALYN DASALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4114 CEDARVALE CT, FAIRFIELD, CA 94534-6618
(707) 816-8897
Mailing address
4114 CEDARVALE CT, FAIRFIELD, CA 94534-6618
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
6683
CA
Other
Enumeration date
07/05/2021
Last updated
07/05/2021
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