Provider Demographics
NPI:1750626859
Name:DESCANZO, JOSE JOVEN PINEDA (PTA)
Entity type:Individual
Prefix:MR
First Name:JOSE JOVEN
Middle Name:PINEDA
Last Name:DESCANZO
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 N HILLVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-3328
Mailing Address - Country:US
Mailing Address - Phone:408-823-0920
Mailing Address - Fax:
Practice Address - Street 1:1450 N HILLVIEW DR
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-3328
Practice Address - Country:US
Practice Address - Phone:408-823-0920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-01
Last Update Date:2012-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9089225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant