Individual
JADE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5849 CROCKER ST, UNIT K, LOS ANGELES, CA 90003-1311
(323) 406-5783
Mailing address
5849 CROCKER ST, UNIT K, LOS ANGELES, CA 90003-1311
(323) 406-5783
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
02/02/2016
Last updated
02/02/2016
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