Provider Demographics
NPI:1700543782
Name:SARMIENTO, JAKE P (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:JAKE
Middle Name:P
Last Name:SARMIENTO
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10702 HORTON AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-2112
Mailing Address - Country:US
Mailing Address - Phone:562-319-9996
Mailing Address - Fax:
Practice Address - Street 1:7921 PROFESSIONAL CIR
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-1901
Practice Address - Country:US
Practice Address - Phone:714-847-8751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-24
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist