Provider Demographics
NPI:1689842890
Name:NARTEA, JOSE A JR (ATC, CSCS, RKC)
Entity Type:Individual
Prefix:MR
First Name:JOSE
Middle Name:A
Last Name:NARTEA
Suffix:JR
Gender:M
Credentials:ATC, CSCS, RKC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6422 DEL AMO BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90713-2204
Mailing Address - Country:US
Mailing Address - Phone:562-425-4759
Mailing Address - Fax:562-425-4708
Practice Address - Street 1:6422 DEL AMO BLVD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90713-2204
Practice Address - Country:US
Practice Address - Phone:562-425-4759
Practice Address - Fax:562-425-4708
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-11
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0101020242255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer