Active NPI
Juan Francisco Trejo Jr., DPT
- Physical Therapist
- Selma, CA
National Provider Identifier
1063819647
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 42176
- Practice address
- 2251 Country Club LN
Selma, CA 93662-3859 - Phone
- (559) 896-6565
- Fax
- (559) 896-5740
- NPI assigned
- Nov 26, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 42176 | CA | Primary |
Addresses
Primary practice location
2251 Country Club LN
Selma, CA 93662-3859
Mailing address
2251 Country Club LN
Selma, CA 93662-3859
Phone (559) 896-6565
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CA143242 | Other | CA | MEDICARE PTAN |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 42176 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427673600000",
"number": "1063819647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2251 COUNTRY CLUB LN",
"city": "SELMA",
"state": "CA",
"postal_code": "936623859",
"telephone_number": "559-896-6565",
"fax_number": "559-896-5740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2251 COUNTRY CLUB LN",
"city": "SELMA",
"state": "CA",
"postal_code": "936623859",
"telephone_number": "559-896-6565",
"fax_number": "559-896-5740"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TREJO",
"first_name": "JUAN",
"middle_name": "FRANCISCO",
"name_suffix": "Jr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-11-26",
"last_updated": "2015-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "42176",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "CA143242",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Selma, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.