Individual
JON R. WASHBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
525 WEST ACACIA STREET, STOCKTON, CA 95203-2405
(209) 944-5550
Mailing address
P.O. BOX 11101, WESTMINSTER, CA 92685-1101
(866) 878-5075
Taxonomy
Speciality
Code
Description
License number
State
146D00000X
Personal Emergency Response Attendant
Primary
PA15880
CA
207P00000X
Emergency Medicine Physician
02A5306
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PA15880
—
CA
Enumeration date
08/07/2006
Last updated
04/22/2008
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