Shaun Nieto, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

50075 Issued in CA

Practice address

517 S a St
517 S a St
Madera, CA 93638

Phone

(559) 673-9228

NPI assigned

Jan 31, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1675123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1306552500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4539 HILLSIDE RD",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936368013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 S A ST",
            "address_2": "517 S A ST",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "93638",
            "telephone_number": "559-673-9228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIETO",
        "first_name": "SHAUN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-31",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "50075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert BV Nguyen, MD
• Timothy Duy Nguyen, PHARMD
• Tran H Nguyen, PHARM. D
• Yona Nicolau, M.D.
• Clara Nielsen, MS, CGC
• Melanie Fumiko Niino, DPT
• Daniel Nolt, PHARMD
• Elijah Nora, DPT
• Northwest Dental Care
• Elizabeth Novy, LCSW

• Physical Therapy Assistant in Madera, CA
• Providers in Madera, CA by specialty
• Physical Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; 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.