Individual
EDWARD JASTIA FERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
3425 W VICTORY BLVD, BURBANK, CA 91505-1545
(818) 955-8855
(818) 955-8833
Mailing address
27125 SIERRA HWY STE 203, CANYON COUNTRY, CA 91351-5429
(661) 250-9940
(661) 250-9959
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
48715
CA
Other
Enumeration date
08/08/2017
Last updated
08/08/2017
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