=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669376240
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HAESEL JABNEEL OSUNA PT, DPT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/06/2026
-----------------------------------------------------
Last Update Date | 10/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 402 S PROSPECTORS RD STE I&E
-----------------------------------------------------
City | DIAMOND BAR
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91765-1618
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 909-922-2497
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12407 1/2 PELLISSIER RD
-----------------------------------------------------
City | WHITTIER
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90601-1544
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 323-413-4686
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 310885
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------