Provider Demographics
NPI:1568860823
Name:JAMES, JAYCEE (NON PHYSICIAN)
Entity Type:Individual
Prefix:
First Name:JAYCEE
Middle Name:
Last Name:JAMES
Suffix:
Gender:M
Credentials:NON PHYSICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17531 HUDSON DRIVE
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395
Mailing Address - Country:US
Mailing Address - Phone:760-596-4517
Mailing Address - Fax:
Practice Address - Street 1:2029 CENTURY PARK E
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90067
Practice Address - Country:US
Practice Address - Phone:760-205-9006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-18
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No175L00000XOther Service ProvidersHomeopath
No175F00000XOther Service ProvidersNaturopath
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No251B00000XAgenciesCase Management