Individual
WENCE CAJUCOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
821 HARRISON ST, OAKLAND, CA 94607-4422
(510) 268-0222
(510) 268-0111
Mailing address
821 HARRISON ST, OAKLAND, CA 94607-4422
(510) 268-0222
(510) 268-0111
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
10231
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10231
PHYSICAL THERAPY BOARD OF CALIFORNIA
CA
Enumeration date
08/12/2014
Last updated
08/12/2014
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