Provider Demographics
NPI:1073911277
Name:JURADO, YOXY
Entity Type:Individual
Prefix:
First Name:YOXY
Middle Name:
Last Name:JURADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:543 E ARROW HWY
Mailing Address - Street 2:APT. 7
Mailing Address - City:AZUSA
Mailing Address - State:CA
Mailing Address - Zip Code:91702-5754
Mailing Address - Country:US
Mailing Address - Phone:626-494-4250
Mailing Address - Fax:
Practice Address - Street 1:543 E ARROW HWY
Practice Address - Street 2:APT. 7
Practice Address - City:AZUSA
Practice Address - State:CA
Practice Address - Zip Code:91702-5754
Practice Address - Country:US
Practice Address - Phone:626-494-4250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-21
Last Update Date:2014-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8840225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist