Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath |
NPI | 1033730692 |
---|---|
Provider Name | Joleen Trear |
First Address | Aliso Viejo, CA 92656-1545 |
Second Address | San Diego, CA 92121-3915 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2020 |
Last Update Date | 05/05/2020 |