Joseph Ezra Ilaoa
Individual provider Active NPI Rehabilitation Practitioner · Richvale, CA
NPI 1245958107 · NPPES record last updated Nov 19, 2025
Key facts
- NPI
- 1245958107
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Rehabilitation Practitioner 225400000X
- Practice address
- 1229 Broadway St
Richvale, CA 95974 - Phone
- (530) 283-3330
- NPI assigned
- Aug 17, 2022
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Rehabilitation Practitioner | 225400000X | Yes |
Addresses
Primary practice location
1229 Broadway St
Richvale, CA 95974
Mailing address
350 Main St
Quincy, CA 95971
Phone (530) 283-3330
Other providers in Richvale, CA
- Monica De Leon
- Aubreyon Douglas
- Jared Shawn Dubose
- Environmental Alternatives
- Rosemary Henman
- Shari Lee Mota
- Derrick Eugene Shepherd
- Arthur Wylie
- Arthur Joe Wylie IV
- Eden Wylie
All providers in Richvale, CA · Rehabilitation Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 19, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.