Healthcare Provider Details

I. General information

NPI: 1609490796
Provider Name (Legal Business Name): JULES SAMONTE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2020
Last Update Date: 06/03/2020
Certification Date: 06/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 SPRINGFIELD DR
CHICO CA
95928-6340
US

IV. Provider business mailing address

1080 E LASSEN AVE APT 41
CHICO CA
95973-0830
US

V. Phone/Fax

Practice location:
  • Phone: 530-342-4885
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number49967
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: