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General NPI Number Information
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NPI Number | 1891211363
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Entity Type | Organization
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Legal Business Name | JTY AND ASSOCIATES, LLC
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Dates
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Enumeration Date | 08/16/2017
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Last Update Date | 08/16/2017
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Provider Practice Location Address
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Address Line | 14025 PARAMOUNT BLVD
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City | PARAMOUNT
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State | CA
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Zip | 90723-2605
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Country | US
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Telephone | 562-331-8881
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Fax | 562-988-3373
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Provider Business Mailing Address
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Address Line | 14025 PARAMOUNT BLVD
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City | PARAMOUNT
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State | CA
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Zip | 90723-2605
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Country | US
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Telephone | 562-331-8881
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Fax | 562-988-3373
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Authorized Official
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Title or Position | CEO
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Name | DR. JENNIFER OLAGUERA TY-DE GUZMAN
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Credential | DNP
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Telephone | 562-331-8881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | NP12561
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License Number State | CA
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