Healthcare Provider Details

I. General information

NPI: 1205746492
Provider Name (Legal Business Name): JAYCEL JAN FRANCISCO MPSS-GLUEWH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6950 EL CAJON BLVD
SAN DIEGO CA
92115-1738
US

IV. Provider business mailing address

6950 EL CAJON BLVD
SAN DIEGO CA
92115-1738
US

V. Phone/Fax

Practice location:
  • Phone: 619-439-2473
  • Fax:
Mailing address:
  • Phone: 619-439-2473
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberMPSS-GLUEWH
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: