Individual
LAQUEEN JORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1532 FRIENZA AVE, SACRAMENTO, CA 95815-2735
(916) 242-5339
Mailing address
1532 FRIENZA AVE, SACRAMENTO, CA 95815-2735
(916) 242-5339
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
146D00000X
Personal Emergency Response Attendant
—
—
163WA2000X
Administrator Registered Nurse
545-7353092
TX
175M00000X
Lay Midwife
—
—
Other
Enumeration date
02/11/2018
Last updated
02/11/2018
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