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SAN JOAQUIN COUNTY CCS NPI 1639264005


NPI Information

NPI: 1639264005
Provider Name: SAN JOAQUIN COUNTY CCS

Doing Business As: MCFALL MTU

Classification: Physical Therapist - 2251P0200X
Entity Type: Organization

Specialization: Pediatrics

Address:
1810 HOYT LN
MANTECA, CA
ZIP 95336
Phone: (209) 982-5159
Get Directions

SAN JOAQUIN COUNTY CCS is a pediatrics physical therapist in Manteca, CA. The provider is a licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Pediatric Physical Therapy, who has demonstrated specialized knowledge and skill in anatomy, histology, including embryonic development, genetics, biomechanics, neurological function, neuroscience, and pathology, behavioral sciences, and understanding of diseases or conditions that necessitate physical therapy care, that affect systems that in turn necessitate physical therapy care (comorbidities), and that influence the type of intervention that can be given. SAN JOAQUIN COUNTY CCS NPI is 1639264005. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Mcfall Mtu.

The provider's business location address is:

1810 HOYT LN
MANTECA, CA
ZIP 95336-354
Phone: (209) 982-5159

The provider's authorized official is Armando Valerio .
The authorized official title is Mtp Manager and has the following contact phone number (209) 953-3617.

The enumeration date for this NPI number is 10/3/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12251P0200XPhysical TherapistPediatricsPT23512CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1CCS00005FMEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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