Provider Demographics
NPI:1346974805
Name:FIGUEROA, JOSE
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:
Last Name:FIGUEROA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7738 WALNUT AVE
Mailing Address - Street 2:
Mailing Address - City:WINTON
Mailing Address - State:CA
Mailing Address - Zip Code:95388-9367
Mailing Address - Country:US
Mailing Address - Phone:209-620-2014
Mailing Address - Fax:
Practice Address - Street 1:7738 WALNUT AVE
Practice Address - Street 2:
Practice Address - City:WINTON
Practice Address - State:CA
Practice Address - Zip Code:95388-9367
Practice Address - Country:US
Practice Address - Phone:209-620-2014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-11
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer