Healthcare Provider Details

I. General information

NPI: 1467919324
Provider Name (Legal Business Name): OVESTER ARMSTRONG JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2019
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WASHINGTON SQ
SAN JOSE CA
95192-1001
US

IV. Provider business mailing address

869 WINNIPEG CT
TRACY CA
95304-5823
US

V. Phone/Fax

Practice location:
  • Phone: 408-924-5678
  • Fax:
Mailing address:
  • Phone: 510-846-0655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: