Provider Demographics
NPI:1598523235
Name:NAVARRO, JESUS MARQUEZ (ATC, PT)
Entity type:Individual
Prefix:
First Name:JESUS
Middle Name:MARQUEZ
Last Name:NAVARRO
Suffix:
Gender:
Credentials:ATC, PT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:546 S SISKIYOU AVE
Mailing Address - Street 2:
Mailing Address - City:KERMAN
Mailing Address - State:CA
Mailing Address - Zip Code:93630-9347
Mailing Address - Country:US
Mailing Address - Phone:559-355-0497
Mailing Address - Fax:
Practice Address - Street 1:6770 N WEST AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-1399
Practice Address - Country:US
Practice Address - Phone:559-713-6806
Practice Address - Fax:559-713-6809
Is Sole Proprietor?:No
Enumeration Date:2024-03-07
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20000512862255A2300X
CA307648225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer