Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jerome Prudencio Jr.

Individual provider Other Technician · NPI 1669082434

Jerome Prudencio Jr. is an Other Technician in Los Angeles, California. Registered with an NPI since 2020.

In the registry since
2020

Practice location Address checks out

145 S Fairfax Ave Fl 2
Los Angeles, CA 90036-2166
Phone: (310) 502-8089
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Other Technician (primary) Taxonomy 247200000X

Record details

NPI number1669082434
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 5, 2020
Last updated in NPPESSeptember 9, 2025
Certification dateSeptember 9, 2025
Mailing address8816 La Riviera Dr Unit D, Sacramento, CA 95826-2075

Other providers in Los Angeles