Individual
ANDREW ELIJAH CABRILLOS JUNTILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
20996 REDWOOD RD, CASTRO VALLEY, CA 94546-5918
Mailing address
20975 MANTER RD, CASTRO VALLEY, CA 94552-4823
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
302957
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
302957
PHYSICAL THERAPY BOARD OF CALIFORNIA
CA
Enumeration date
09/28/2022
Last updated
09/28/2022
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