Individual
JIKKO JOVEN BAUTISTA DEL ROSARIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8207 LAUREL AVE, FONTANA, CA 92335-3723
(626) 824-6144
Mailing address
8207 LAUREL AVE, FONTANA, CA 92335-3723
(626) 824-6144
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4923
CA
Other
Enumeration date
02/09/2023
Last updated
02/09/2023
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