Healthcare Provider Details

I. General information

NPI: 1588969927
Provider Name (Legal Business Name): JAYMESON LOKELA SANCHEZ M.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2011
Last Update Date: 01/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 1/2 SACRAMENTO ST
VALLEJO CA
94590-5917
US

IV. Provider business mailing address

508 1/2 SACRAMENTO ST
VALLEJO CA
94590-5917
US

V. Phone/Fax

Practice location:
  • Phone: 510-379-8421
  • Fax:
Mailing address:
  • Phone: 510-379-8421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: