Individual
JOSE JAIME BEDOLLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3601 CALLE TECATE STE 201, CAMARILLO, CA 93012-5056
(805) 289-0120
(805) 289-0130
Mailing address
3601 CALLE TECATE STE 201, CAMARILLO, CA 93012-5290
(805) 289-0120
(805) 289-0130
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
225400000X
Rehabilitation Practitioner
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
56CC
ASPIRA
CA
Enumeration date
12/01/2022
Last updated
06/30/2026
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