Individual provider Active NPI

Josue Bernal Huerta

  • Physical Therapy Assistant
  • Los Banos, CA
National Provider Identifier
1477327807
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
52957 Issued in CA
Practice address
1400 S Mercey Springs Rd
Los Banos, CA 93635-4928
Phone
(209) 710-1013
NPI assigned
Nov 7, 2023
Last updated
Nov 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 52957 CA Primary

Addresses

Primary practice location

1400 S Mercey Springs Rd
Los Banos, CA 93635-4928

Mailing address

305 Banner CT
Modesto, CA 95356-9261
Phone (209) 710-1013

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

State licenses

LicenseStateTypeSpecialty
52957CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1699315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1477327807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 BANNER CT",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569261",
            "telephone_number": "209-710-1013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S MERCEY SPRINGS RD",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936354928",
            "telephone_number": "209-710-1013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUERTA",
        "first_name": "JOSUE",
        "middle_name": "BERNAL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-07",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "52957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Banos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.