Individual
LISA A. JAIME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
40657 ROAD 128, CUTLER, CA 93615-2003
(559) 528-3860
(559) 528-6798
Mailing address
1479 W LACEY BLVD, HANFORD, CA 93230-5906
(559) 583-4617
(559) 583-4625
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA20112
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA20112
CA STATE LICIENSE NUMBER
CA
Enumeration date
12/22/2008
Last updated
08/14/2014
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