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

Jessie Tavarro

Individual provider Physical Therapy Assistant · NPI 1811572902

Jessie Tavarro is a Physical Therapy Assistant in Downey, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2021

Practice location Address checks out

12555 Lakewood Blvd Ste F
Downey, CA 90242-2771
Phone: (562) 923-4704
Show map & directions

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

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence PTA48319 (CA)

Record details

NPI number1811572902
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMarch 10, 2021
Last updated in NPPESMarch 10, 2021
Certification dateMarch 10, 2021
Mailing address544 S Devon Rd, Orange, CA 92868-4520

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