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General NPI Number Information
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NPI Number | 1568340214
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Entity Type | Individual
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Provider Name | JAVIER ALEXIS OSORNIO DPT
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Gender | Male
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Dates
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Enumeration Date | 08/21/2025
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 50 IRON POINT CIR STE 100
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City | FOLSOM
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State | CA
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Zip | 95630-8594
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Country | US
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Telephone | 916-836-1111
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Fax |
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Provider Business Mailing Address
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Address Line | 486 REINDOLLAR AVE
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City | MARINA
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State | CA
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Zip | 93933-3733
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Country | US
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Telephone | 831-747-0953
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 308782
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License Number State | CA
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