Jessica Mirella Banuelos
NPI #1205189578 in Hawaiian Gardens, California
Provider Information
- NPI Number
- 1205189578
- Entity Type
- Individual
- Name
- Jessica Mirella Banuelos
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Rehabilitation Practitioner
- Enumeration Date
- Oct 23, 2012
- Last Updated
- Oct 23, 2012
Practice Location
- Address
- 21520 PIONEER BLVD STE 101
- City
- Hawaiian Gardens
- State
- California
- ZIP Code
- 90716-2603
- Phone
- (562) 246-5700
Specialties & Taxonomy Codes
| Specialty |
|---|
| Rehabilitation Practitioner |
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