Individual
JAISHAWN LENNA BROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1160 E SOUTH ST APT 2, LONG BEACH, CA 90805-4141
(562) 850-6496
Mailing address
1160 E SOUTH ST APT 2, LONG BEACH, CA 90805-4141
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
01/24/2020
Last updated
01/24/2020
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