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Dejah Archer
Student in an Organized Health Care Education/Training Program in South Pasadena, California
NPI 1336853696

Dejah Archer is a Student in an Organized Health Care Education/Training Program based in South Pasadena, CA. Dejah Archer practices in South Pasadena, CA. The NPI Number for Dejah Archer is 1336853696 and holds a License No. (California).

The current practice location address for Dejah Archer is 205 Pasadena Ave, South Pasadena, CA and can be reached out via phone at 323-344-5536.

Location: 205 Pasadena Ave, South Pasadena, CA, 91030-2919
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1336853696
Provider Name
Dejah Archer
Credential
Provider Entity Type
Individual
Gender
Female
Address
205 Pasadena Ave, South Pasadena, CA, 91030-2919
Phone Number
323-344-5536
Fax Number
Provider Enumeration Date
01/11/2023
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
7184 01 CA MEDICAL
7368 01 CA MEDICAL
7667 01 CA MEDICAL
7708 01 CA MEDICAL
institution
Provider Business Practice Location Address Details
Address
205 Pasadena Ave
City
South Pasadena
State
California
Zip
91030-2919
Phone Number
323-344-5536
Fax Number
person
Provider Business Mailing Address Details
Address
205 Pasadena Ave
City
South Pasadena
State
California
Zip
91030-2919
Phone Number
323-344-5536
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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