Provider Demographics
NPI:1598702136
Name:ROBERTS, JEFFREY JAMES (MS, ATC, NASM-PES)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:JAMES
Last Name:ROBERTS
Suffix:
Gender:M
Credentials:MS, ATC, NASM-PES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 VIA SORRENTO
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-5744
Mailing Address - Country:US
Mailing Address - Phone:408-776-6773
Mailing Address - Fax:
Practice Address - Street 1:SAN JOSE STATE UNIVERSITY
Practice Address - Street 2:DEPARTMENT OF KINESIOLOGY
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95192-0001
Practice Address - Country:US
Practice Address - Phone:408-924-3035
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist