Provider Demographics
NPI:1447737713
Name:TOLENTINO, JESSICA MAE
Entity type:Individual
Prefix:
First Name:JESSICA MAE
Middle Name:
Last Name:TOLENTINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2335 VISTA WAY # A
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-5663
Mailing Address - Country:US
Mailing Address - Phone:760-547-2666
Mailing Address - Fax:
Practice Address - Street 1:2335 VISTA WAY # A
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-5663
Practice Address - Country:US
Practice Address - Phone:760-547-2666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-19
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant