Jessica Natasha Antwine

Individual provider Active NPI Chore Provider · Lafayette, CA

NPI 1992576045 · NPPES record last updated Jan 9, 2024

Key facts

NPI
1992576045
Entity type
Individual (NPI type 1)
Primary specialty
Chore Provider 372500000X
Practice address
412 Vienx Orleans Circle Apt C
Lafayette, CA 70508
Phone
(337) 443-3323
NPI assigned
Jan 9, 2024
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chore Provider 372500000X Yes

Addresses

Primary practice location

412 Vienx Orleans Circle Apt C
Lafayette, CA 70508

Mailing address

412 Vienx Orleans Circle Apt C
Lafayette, CA 70508
Phone (337) 443-3323

Other providers in Lafayette, CA

All providers in Lafayette, CA · Chore Provider in California

Sources for this page

Verify at the official NPI Registry.