Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175F00000X | Naturopath | ||
N | 175L00000X | Homeopath |
NPI | 1568860823 |
---|---|
Provider Name | Jaycee James |
First Address | Victorville, CA 92395 |
Second Address | Los Angeles, CA 90067 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2014 |
Last Update Date | 23/01/2015 |