Provider Demographics
NPI:1285420174
Name:GLORIA, JARED MICHAEL
Entity type:Individual
Prefix:MR
First Name:JARED
Middle Name:MICHAEL
Last Name:GLORIA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3562 IGNACIO CIR
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95209-3901
Mailing Address - Country:US
Mailing Address - Phone:209-684-3816
Mailing Address - Fax:
Practice Address - Street 1:2510 N CALIFORNIA ST
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95204-5502
Practice Address - Country:US
Practice Address - Phone:209-938-0831
Practice Address - Fax:209-938-0849
Is Sole Proprietor?:No
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program