Healthcare Provider Details

I. General information

NPI: 1770711756
Provider Name (Legal Business Name): JAIME ROSANNA PARKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2009
Last Update Date: 06/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1929 OXFORD CT
SALINAS CA
93906-2184
US

IV. Provider business mailing address

24 CUESTA VISTA DR
MONTEREY CA
93940-4306
US

V. Phone/Fax

Practice location:
  • Phone: 831-771-8555
  • Fax:
Mailing address:
  • Phone: 831-915-0864
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: