Individual
DAVID JACABAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9961 SIERRA AVE, FONTANA, CA 92335-6720
(909) 427-4075
Mailing address
11968 GEMSTONE CT, YUCAIPA, CA 92399-3491
Taxonomy
Speciality
Code
Description
License number
State
225XN1300X
Neurorehabilitation Occupational Therapist
Primary
OT 3235
CA
Other
Enumeration date
04/20/2007
Last updated
11/30/2021
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