Individual
CASEY JACKLYN LESTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
960 W HEDDING ST, SAN JOSE, CA 95126-1215
(408) 537-9229
Mailing address
9065 KERN AVE, GILROY, CA 95020-7543
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000029287
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000029287
NATA BOC ATC
CA
Enumeration date
08/29/2017
Last updated
06/16/2018
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