Provider Demographics
NPI:1033730692
Name:TREAR, JOLEEN
Entity Type:Individual
Prefix:
First Name:JOLEEN
Middle Name:
Last Name:TREAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JOLEEN
Other - Middle Name:MICHIKO
Other - Last Name:TREAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ND
Mailing Address - Street 1:5 LARKMEAD
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-1545
Mailing Address - Country:US
Mailing Address - Phone:949-445-2827
Mailing Address - Fax:
Practice Address - Street 1:6498 WEATHERS PL STE 100
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-3915
Practice Address - Country:US
Practice Address - Phone:858-412-5744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-05
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty