Provider Demographics
NPI:1316324718
Name:ARGUELLO, JESSICA (CAMT)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:
Last Name:ARGUELLO
Suffix:
Gender:F
Credentials:CAMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 N SANTA CRUZ AVE STE B
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95030-4355
Mailing Address - Country:US
Mailing Address - Phone:408-802-1206
Mailing Address - Fax:
Practice Address - Street 1:501 N SANTA CRUZ AVE STE B
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95030-4355
Practice Address - Country:US
Practice Address - Phone:408-802-1206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-05
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65823173C00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No173C00000XOther Service ProvidersReflexologist