Individual
OLIVIA RAVEN JUENGST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4294 CALAVO DR, LA MESA, CA 91941-7008
(619) 724-9765
Mailing address
4294 CALAVO DR, LA MESA, CA 91941-7008
(619) 724-9765
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
01232368
CA
Other
Enumeration date
09/23/2022
Last updated
09/23/2022
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