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General NPI Number Information
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NPI Number | 1942427984
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Entity Type | Individual
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Provider Name | MS. MARSHA L JESSEE
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Gender | Female
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1054 2ND ST
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City | ENCINITAS
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State | CA
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Zip | 92024-5009
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Country | US
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Telephone | 760-942-4422
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Fax |
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Provider Business Mailing Address
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Address Line | 875 HOLLYHOCK CT
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City | CARLSBAD
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State | CA
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Zip | 92011-3821
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Country | US
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Telephone | 760-807-1346
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 17104
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License Number State | CA
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