NPIMap

Individual provider Active NPI

Theresa Ann Stofan, P.T.

  • Physical Therapist
  • Fresno, CA
National Provider Identifier
1063423945
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT14810 Issued in CA
Practice address
6121 N Thesta St
Suite 115
Fresno, CA 93710-8603
Phone
(559) 449-9394
Fax
(559) 449-8287
NPI assigned
Aug 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT14810 CA Primary

Addresses

Primary practice location

6121 N Thesta St
Suite 115
Fresno, CA 93710-8603

Mailing address

6121 N Thesta St
Suite 115
Fresno, CA 93710-8603
Phone (559) 449-9394

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT14810CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
S.T.a.R. Therapy Clinic, Inc Physical Therapist Past Accepting new patients
L.B. Consulting Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063423945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6121 N THESTA ST",
            "address_2": "SUITE 115",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937108603",
            "telephone_number": "559-449-9394",
            "fax_number": "559-449-8287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6121 N THESTA ST",
            "address_2": "SUITE 115",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937108603",
            "telephone_number": "559-449-9394",
            "fax_number": "559-449-8287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOFAN",
        "first_name": "THERESA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT14810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.