Provider Demographics
NPI:1225232127
Name:SORIA, JAYSON JOHN SABIO (MPT)
Entity Type:Individual
Prefix:MR
First Name:JAYSON
Middle Name:JOHN SABIO
Last Name:SORIA
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 SPANISH OAK LANE
Mailing Address - Street 2:
Mailing Address - City:LA PUENTE
Mailing Address - State:CA
Mailing Address - Zip Code:91746
Mailing Address - Country:US
Mailing Address - Phone:626-617-7063
Mailing Address - Fax:
Practice Address - Street 1:18126 E NEWBURGH ST
Practice Address - Street 2:
Practice Address - City:AZUSA
Practice Address - State:CA
Practice Address - Zip Code:91702-5816
Practice Address - Country:US
Practice Address - Phone:626-617-7063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28660225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist