Most Relevant Information
Provider Data
| NPI Number: | 1003517830 |
| Provider Name: | JIZELLE JAELYNN KAULU NMT |
| Entity Type: | Individual |
| Taxonomy Code: | 225700000X |
| Specialty: | Massage Therapist |
| License Number: | 92755 |
Most Important Dates
| Enumeration Date: | 03/17/2023 |
| Last Updated: | 03/17/2023 |
Provider Practice Location
64 HARKNESS AVE APT 6
PASADENA
CA
911062038
Practice Location Phone/Fax
| Phone: | 3107804386 |
| Fax: |
Provider Mailing Location
64 HARKNESS AVE APT 6
PASADENA
CA
911062038
Provider Mailing Phone/Fax
| Phone: | 3107804386 |
| Fax: |