Individual
JACOB RYAN DAMANTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS OTR/L
Contact information
Practice address
4964 TELEGRAPH RD, VENTURA, CA 93003-8181
(805) 856-9000
Mailing address
622 LANTANA ST APT 53, CAMARILLO, CA 93010-6113
(530) 219-5898
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
22430
CA
225X00000X
Occupational Therapist
6915
AZ
Other
Enumeration date
11/13/2017
Last updated
06/15/2022
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