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NPI Code Detail

MEDICARE: JOSE ROMAN JR.

MEDICARE: JOSE ROMAN JR.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1373H00000XDay Training/Habilitation Specialist

General Provider Information

NPI Number : 1578217238
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSE ROMAN JR.
Provider Business Mailing Address
First Line : 202 N 8TH ST
Second Line :
City : EL CENTRO
State : CA
Zip : 92243-2302
Country : US
Telephone Number : 442-265-1525
Fax Number :
Provider Business Practice Location Address
First Line : 202 N 8TH ST
Second Line :
City : EL CENTRO
State : CA
Zip : 92243-2302
Country : US
Telephone Number : 442-265-1525
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2022
Last Update Date : 12/15/2025

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