Individual provider Active NPI

Joshua Austin Enriquez Victorio

  • Physical Therapy Assistant
  • Walnut, CA
National Provider Identifier
1003653106
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
51609 Issued in CA
Practice address
19462 Empty Saddle Rd
Walnut, CA 91789-4290
Phone
(626) 877-1664
NPI assigned
Jul 15, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 51609 CA Primary

Addresses

Primary practice location

19462 Empty Saddle Rd
Walnut, CA 91789-4290

Mailing address

19462 Empty Saddle Rd
Walnut, CA 91789-4290
Phone (626) 877-1664

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1721001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1003653106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19462 EMPTY SADDLE RD",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "917894290",
            "telephone_number": "626-877-1664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19462 EMPTY SADDLE RD",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "917894290",
            "telephone_number": "626-877-1664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICTORIO",
        "first_name": "JOSHUA",
        "middle_name": "AUSTIN ENRIQUEZ",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-15",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "51609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.