Healthcare Provider Details

I. General information

NPI: 1629952817
Provider Name (Legal Business Name): JENNIFER ARAGON CRUZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2025
Last Update Date: 08/01/2025
Certification Date: 08/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 CRANBURY RD
EAST BRUNSWICK NJ
08816-3062
US

IV. Provider business mailing address

841 FAIR OAKS AVE
ARROYO GRANDE CA
93420-3908
US

V. Phone/Fax

Practice location:
  • Phone: 805-361-7727
  • Fax:
Mailing address:
  • Phone: 805-710-2859
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: