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Individual

MRS. JOYCE A JACOB

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SCHOOL NURSE

Contact information

Practice address
3204 CANAL POINT DR, HACIENDA HEIGHTS, CA 91745-6121
(626) 333-5155
Mailing address
3204 CANAL POINT DR, HACIENDA HEIGHTS, CA 91745-6121
(626) 333-5155

Taxonomy

Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
129068
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
SDT35626
SCHOOL NURSE
CA
Enumeration date
09/29/2011
Last updated
09/29/2011
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