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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JASON JOSHUA CODILLA

Active Sole Proprietor

JASON JOSHUA CODILLA is a Optician healthcare provider located in SAN LEANDRO, California. NPI 1053172692 is currently active in the NPPES registry. Verify at CMS.

Optician · SAN LEANDRO, CA

Registration Details

NPI Number
1053172692
Provider Type
Individual
Gender
Male
NPI Issued
Jan 22, 2024 (2.586985332984 yrs)
Last Updated
Jan 22, 2024
Sole Proprietor
Yes

Practice Information

Address
2500 MERCED ST
SAN LEANDRO, CA, 945774201
Browse CA providers · Browse ZIP 94577
Phone
5104541000
Primary Specialty
Optician
156F00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.