Active NPI
Bonhoeffer Estrella, PT
- Physical Therapist
- Manteca, CA
National Provider Identifier
1194346833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 33740
- Practice address
- 410 Eastwood Ave
Manteca, CA 95336-3167 - Phone
- (209) 239-1222
- NPI assigned
- May 5, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 | 33740 | CA | Primary |
Addresses
Primary practice location
410 Eastwood Ave
Manteca, CA 95336-3167
Mailing address
1120 Livorno CT
Manteca, CA 95337-8441
Phone (317) 457-5306
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": "1588636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588636800000",
"number": "1194346833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1120 LIVORNO CT",
"city": "MANTECA",
"state": "CA",
"postal_code": "953378441",
"telephone_number": "317-457-5306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "410 EASTWOOD AVE",
"city": "MANTECA",
"state": "CA",
"postal_code": "953363167",
"telephone_number": "209-239-1222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESTRELLA",
"first_name": "BONHOEFFER",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-05-05",
"last_updated": "2020-05-05",
"certification_date": "2020-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "33740",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manteca, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.