Individual
JESSICA TELLO-EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.S.N., R.N., P.H.N.
Contact information
Practice address
275 BECK AVE, FAIRFIELD, CA 94533-6804
(707) 784-8614
(707) 421-6618
Mailing address
1748 NEWARK LN, SUISUN CITY, CA 94585-6323
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
628963
CA
Other
Enumeration date
01/16/2007
Last updated
07/08/2007
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