Provider Demographics
NPI:1407064876
Name:RESARI, JESSE CIMANES (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:JESSE
Middle Name:CIMANES
Last Name:RESARI
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:DR
Other - First Name:JESSE
Other - Middle Name:
Other - Last Name:RESARI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:7333 FOXGLOVE PL
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-3187
Mailing Address - Country:US
Mailing Address - Phone:909-827-8846
Mailing Address - Fax:909-452-7718
Practice Address - Street 1:9471 HAVEN AVE
Practice Address - Street 2:SUITE 130
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-5844
Practice Address - Country:US
Practice Address - Phone:909-827-8846
Practice Address - Fax:909-452-7718
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA303412251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic