La Rosa, Jethro Payne De Vega

La Rosa, Jethro Payne De Vega is an individual health care provider with primary practice located at 39210 State St Suite 202, Fremont CA 94538-1456. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as his primary health care specialty. La Rosa, Jethro Payne De Vega can be contacted via phone (510) 790-9480.

Contact Information

Primary practice address
39210 State St Suite 202 Fremont CA 94538-1456
Phone: (510) 790-9480
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X California

Profile Details

NPI number 1720422983
LBN Legal business name La Rosa, Jethro Payne De Vega
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2013
Last updated Apr 18th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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