Provider Information for 1881250009
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JENNIFER ROCHE-SHEETS
Sex: Female
NPI: 1881250009
Last Updated: 2019-05-13
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1881250009 | ||||||||||||
| Enumeration Date | 2019-05-13 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 20133 JERSEY AVE LAKEWOOD, CA 90715-1047 United States Phone: | Fax: | ||||||||||||
| Primary Practice Address | 20133 JERSEY AVE LAKEWOOD, CA 90715-1047 United States Phone: 801-791-9801 | Fax: | ||||||||||||
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