Healthcare Provider Details

I. General information

NPI: 1669376240
Provider Name (Legal Business Name): HAESEL JABNEEL OSUNA PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 S PROSPECTORS RD STE I&E
DIAMOND BAR CA
91765-1618
US

IV. Provider business mailing address

12407 1/2 PELLISSIER RD
WHITTIER CA
90601-1544
US

V. Phone/Fax

Practice location:
  • Phone: 909-922-2497
  • Fax:
Mailing address:
  • Phone: 323-413-4686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number310885
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: