Provider Demographics
NPI:1932377041
Name:ROY, RAYMUNDO NUECA JR (PT)
Entity Type:Individual
Prefix:MR
First Name:RAYMUNDO
Middle Name:NUECA
Last Name:ROY
Suffix:JR
Gender:M
Credentials:PT
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Mailing Address - Street 1:4055 EVERGREEN VILLAGE SQ
Mailing Address - Street 2:STE. 260
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95135-1748
Mailing Address - Country:US
Mailing Address - Phone:408-265-2448
Mailing Address - Fax:408-531-1374
Practice Address - Street 1:4055 EVERGREEN VILLAGE SQ
Practice Address - Street 2:STE. 260
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95135-1748
Practice Address - Country:US
Practice Address - Phone:408-265-2448
Practice Address - Fax:408-531-1374
Is Sole Proprietor?:No
Enumeration Date:2008-02-12
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA34474225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist