Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 6912 | CA |
NPI | 1013441153 |
---|---|
Provider Name | Jaybee Dumaguin |
First Address | American Canyon, CA 94503-1206 |
Second Address | American Canyon, CA 94503-1206 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2017 |
Last Update Date | 15/04/2017 |