Provider Demographics
NPI:1528170834
Name:MIRELES, JAIME (BA)
Entity type:Individual
Prefix:MR
First Name:JAIME
Middle Name:
Last Name:MIRELES
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1380 OAK HILL DR SPC 29
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92027-3622
Mailing Address - Country:US
Mailing Address - Phone:619-207-7583
Mailing Address - Fax:619-420-8722
Practice Address - Street 1:1124 BAY BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-7155
Practice Address - Country:US
Practice Address - Phone:619-207-7583
Practice Address - Fax:619-420-8722
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor