Individual
ISSIMA JAVON CALDWELL JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1005 E PESCADERO AVE # SITE211, TRACY, CA 95304-8503
(209) 767-2895
Mailing address
2725 PAVILION PKWY APT 7216, TRACY, CA 95304-9590
(209) 767-2895
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
1503552
CA
174H00000X
Health Educator
1503552
CA
224Y00000X
Clinical Exercise Physiologist
1503552
CA
Other
Enumeration date
12/18/2024
Last updated
01/12/2025
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