Search › Alaska › 106S00000X
Jamie Custodio
NPI 1205339470 · on the registry since 2018
Practice
- Address
- 2462 Bald Eagle Ln Apt D
Eielson Afb, AK 99702 - Phone
- (925) 305-6722
Registry record
- Primary taxonomy
- 106S00000X
106S00000X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2025-01-17
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Alaska