Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175F00000X | Naturopath | CA |
NPI | 1023286994 |
---|---|
Provider Name | Miss Jamilah El Elite |
First Address | Hercules, CA 94547-3848 |
Second Address | Crockett, CA 94525-1176 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2008 |
Last Update Date | 13/02/2008 |