Individual
JACQUELINE LEYVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15482 PASADENA AVE APT 34, TUSTIN, CA 92780-4253
(714) 875-4755
Mailing address
15482 PASADENA AVE APT 34, TUSTIN, CA 92780-4253
(714) 875-4755
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
F3039254
CA
Other
Enumeration date
10/28/2014
Last updated
10/28/2014
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