Genesis

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

8284 Issued in CA

Legal business name

GENESIS

Practice address

2098 Henderson Way
Lodi, CA 95242-4814

Phone

(925) 360-3632

NPI assigned

Jun 20, 2016

Last updated

Jun 20, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Pearl Sotelo

Title

Pta

Phone

(925) 360-3632

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1466380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466380800000",
    "number": "1023468071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2098 HENDERSON WAY",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952424814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2098 HENDERSON WAY",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952424814",
            "telephone_number": "925-360-3632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-20",
        "last_updated": "2016-06-20",
        "status": "A",
        "authorized_official_last_name": "SOTELO",
        "authorized_official_first_name": "PEARL",
        "authorized_official_title_or_position": "PTA",
        "authorized_official_telephone_number": "925-360-3632",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "8284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joanne Marie Garvey
• Leanndra Krystyne Garza, MFT
• Joseph D Gayagoy, M.D.
• Elizabeth Marie Gaydon
• Lauren Geib
• Genxan Transport LLC
• James Douglas Gerard, D.C
• Fatema Manekia Ghani, DPT
• Mobin P Ghavami, M.D.
• Ghozlan Dental Corp.

• Physical Therapy Clinic/Center in Lodi, CA
• Providers in Lodi, CA by specialty
• Physical Therapy Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2016; 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.