Provider Demographics
NPI:1942942453
Name:JAUREGUI, ANDREA (PTA)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:
Last Name:JAUREGUI
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MS
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:ZARAGOZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:414 E SAN BERNARDINO RD
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-1704
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2641 HAMNER AVE STE 110
Practice Address - Street 2:
Practice Address - City:NORCO
Practice Address - State:CA
Practice Address - Zip Code:92860
Practice Address - Country:US
Practice Address - Phone:626-536-4834
Practice Address - Fax:626-507-6319
Is Sole Proprietor?:No
Enumeration Date:2022-04-13
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant