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General NPI Number Information
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NPI Number | 1013148428
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Entity Type | Individual
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Provider Name | JESSY DAYA-WASHBURN L.AC.
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Gender | Female
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Dates
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Enumeration Date | 08/03/2009
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Last Update Date | 08/03/2009
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Provider Practice Location Address
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Address Line | 10 JACKSON ST SUITE 103B
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City | LOS GATOS
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State | CA
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Zip | 95030-7141
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Country | US
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Telephone | 408-656-9648
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Fax |
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Provider Business Mailing Address
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Address Line | 110 OAK RIM CT APT 34
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City | LOS GATOS
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State | CA
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Zip | 95032-3403
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 12889
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License Number State | CA
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