Individual
JERRY ANN SCALES-GRADFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7636 MONTEREY AVE, CERES, CA 95307-9542
(209) 596-7737
Mailing address
7636 MONTEREY AVE, CERES, CA 95307-9542
(209) 596-7737
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
CA
Enumeration date
01/14/2022
Last updated
01/14/2022
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