Provider Demographics
NPI:1043000151
Name:DELA CRUZ, JASON CHRISTOPHER
Entity type:Individual
Prefix:
First Name:JASON CHRISTOPHER
Middle Name:
Last Name:DELA CRUZ
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 FAIRVIEW AVE APT 11
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-6730
Mailing Address - Country:US
Mailing Address - Phone:818-334-7576
Mailing Address - Fax:
Practice Address - Street 1:15768 ARROW HWY
Practice Address - Street 2:
Practice Address - City:IRWINDALE
Practice Address - State:CA
Practice Address - Zip Code:91706-2005
Practice Address - Country:US
Practice Address - Phone:626-969-9800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA307982225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist