Individual provider · Type 1 NPI

Jerome Prudencio Jr.

Other Technician · Los Angeles, CA

NPI number 1669082434 Active

Practice location

145 S Fairfax Ave Fl 2
Los Angeles, CA 90036-2166

Call (310) 502-8089 Map

Mailing address

8816 La Riviera Dr Unit D
Sacramento, CA 95826-2075

Specialties and licenses

TaxonomyCodeLicense
Other Technician Primary 247200000XNone listed

Other Technician: A collective term for persons with specialized training in various narrow fields of expertise whose occupations require training and skills in specific technical processes and procedures; and where further classification is deemed unnecessary by the user.

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About NPI 1669082434

Jerome Prudencio Jr.'s National Provider Identifier is 1669082434, issued on Aug 5, 2020. The primary taxonomy on file is Other Technician (247200000X), and the practice location is in Los Angeles, CA. The record was last updated on Sep 9, 2025.