Individual
JERICA GAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
2080 S E ST, SAN BERNARDINO, CA 92408-2706
(909) 388-9191
Mailing address
3720 1/2 DONALD AVE, RIVERSIDE, CA 92503-4373
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN 280923
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124100383
—
CA
Enumeration date
10/29/2008
Last updated
11/10/2014
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