Provider Demographics
NPI:1255219606
Name:REAL, KOBE JMET VALENCIA
Entity type:Individual
Prefix:
First Name:KOBE JMET
Middle Name:VALENCIA
Last Name:REAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37171 SYCAMORE ST APT 720
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:CA
Mailing Address - Zip Code:94560-5908
Mailing Address - Country:US
Mailing Address - Phone:510-586-8584
Mailing Address - Fax:
Practice Address - Street 1:850 WEBSTER ST
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-2849
Practice Address - Country:US
Practice Address - Phone:650-327-0950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA308774225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist