Individual
DEJANAE HAIRSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IDC
Contact information
Practice address
34800 BOB WILSON DRIVE, SAN DIEGO, CA 92134
(619) 532-6666
Mailing address
34800 BOB WILSON DR, SAN DIEGO, CA 92134-1098
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
04/19/2018
Last updated
04/19/2018
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