Individual
MRS. JESSICA LEE TRUAX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
800 W COVINA BLVD, SAN DIMAS, CA 91773-2476
(626) 695-3704
Mailing address
10034 PALO ALTO ST, RANCHO CUCAMONGA, CA 91730-1541
(626) 695-3704
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
090402210
NATIONAL ATHLETIC TRAINERS ASSOCIATION
CA
Enumeration date
02/19/2021
Last updated
08/06/2021
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