NPI 1952599722

Jesse Detorres, CO

Practitioner Orthotist Oakland, CA

Practice location

Address: 433 Hegenberger Rd STE 100, Oakland, CA 94621-1448
Phone: (510) 430-2500

Registered specialties

Orthotist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 222Z00000X

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Registry record

NPI: 1952599722
Entity type: Individual
Sex (as registered): Male
NPI issued: 5 Oct 2007
Record last updated: 5 Oct 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.