Individual
JEFREY CARBALLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
24124 VISTA HILLS DR, VALENCIA, CA 91355-2835
(310) 717-1989
Mailing address
24124 VISTA HILLS DR, VALENCIA, CA 91355-2835
(310) 717-1989
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
67892
CA
Other
Enumeration date
11/30/2021
Last updated
11/30/2021
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