Individual
MR. REYNALDO BALLESTEROS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
646 ARCHER CT, VALLEJO, CA 94591-8523
(707) 315-8755
Mailing address
646 ARCHER CT, VALLEJO, CA 94591-8523
(707) 315-8755
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
13891
CA
Other
Enumeration date
11/06/2014
Last updated
11/06/2014
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