Individual
JASPER TUCKER III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14148 FRANCISQUITO AVE, BALDWIN PARK, CA 91706-6120
(626) 388-2700
Mailing address
16818 DOWNEY AVE APT 16, PARAMOUNT, CA 90723-5641
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
123005
TX
225X00000X
Occupational Therapist
Primary
25318
CA
225X00000X
Occupational Therapist
OTT.200841
LA
Other
Enumeration date
02/28/2024
Last updated
02/28/2024
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