Individual
JESSICA BLAIR LYDIARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4094 4TH AVE, SAN DIEGO, CA 92103-2143
(305) 355-8128
Mailing address
1611 NW 12TH AVE, MIAMI, FL 33136-1005
(305) 355-8128
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
A171775
CA
Other
Enumeration date
03/19/2017
Last updated
02/01/2022
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