Individual
JASMINE NICOLE TAVAREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
330 MOSS ST, CHULA VISTA, CA 91911-2005
(619) 426-6310
Mailing address
330 MOSS ST, CHULA VISTA, CA 91911-2005
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
02/03/2021
Last updated
02/03/2021
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