NPIMap

Organization Active NPI

San Joaquin County CCS

Doing business as McFall Mtu

  • Pediatric Physical Therapist
  • Manteca, CA
National Provider Identifier
1639264005
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
PT23512 Issued in CA
Legal business name
SAN JOAQUIN COUNTY CCS
Doing business as
McFall Mtu
Practice address
1810 Hoyt LN
Manteca, CA 95336-6354
Phone
(209) 982-5159
NPI assigned
Oct 3, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Armando Valerio, PT,DPT
Title
MTP Manager
Phone
(209) 953-3617

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X PT23512 CA Primary

Addresses

Primary practice location

1810 Hoyt LN
Manteca, CA 95336-6354

Mailing address

PO Box 2009
Stockton, CA 95201-2009
Phone (209) 953-3617

Other identifiers 1

IdentifierTypeStateIssuer
CCS00005FMedicaidCA

Other names 1

  • MCFALL MTU Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Public HLTH Lab San Joa94 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1810 Hoyt Ln
Manteca, CA 95336
Phone (209) 982-5159

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639264005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2009",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952012009",
            "telephone_number": "209-953-3617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 HOYT LN",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953366354",
            "telephone_number": "209-982-5159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN JOAQUIN COUNTY CCS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VALERIO",
        "authorized_official_first_name": "ARMANDO",
        "authorized_official_title_or_position": "MTP MANAGER",
        "authorized_official_telephone_number": "209-953-3617",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT,DPT"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "CA",
            "license": "PT23512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CCS00005F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MCFALL MTU",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 22, 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.

Verify at the official NPI Registry.