Individual provider Active NPI

Emily L Watts, DPT

  • Physical Therapist
  • Stockton, CA
National Provider Identifier
1710269246
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT34560 Issued in CA
Practice address
4343 Pacific Ave Ste B1
Stockton, CA 95207-7664
Phone
(209) 425-4071
Fax
(209) 451-5687
NPI assigned
Sep 10, 2011
Last updated
Sep 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT34560 CA Primary

Addresses

Primary practice location

4343 Pacific Ave Ste B1
Stockton, CA 95207-7664

Mailing address

408 Higuera St Ste 200
San Luis Obispo, CA 93401-6135
Phone (805) 788-0805

Other practice location 1

2401 W Turner Rd
Suite 250
Lodi, CA 95242-2182
Phone (209) 334-2224

Other names 1

  • Emily L Enescu Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111128000679 CA Practitioner - Physical Therapist in Private Practice 4486828670 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2401 W Turner Rd
Suite 250
Lodi, CA 95242-2192
Phone (209) 334-2224

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34560CAMDOptometrist
PT34560CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
San Luis Physical Therapy & Orthopedic Rehabilitation Inc Physical Therapist Current Accepting new patients
San Luis Physical Therapy & Orthopedic Rehabilitation Inc Physical Therapist CurrentSince Oct 31, 2011 Accepting new patients
San Luis Physical Therapy & Orthopedic Rehabilitation Inc Physical Therapist CurrentSince Oct 31, 2011 Accepting new patients
CV Physical Therapy, Inc. Physical Therapist CurrentSince Sep 9, 2011 Accepting new patients
CV Physical Therapy, Inc Physical Therapist CurrentSince Sep 24, 2023 Accepting new patients

Locations

1067 C St
Ste 110
Galt, CA 95632
Phone (209) 745-5802

2401 W Turner Rd
Ste 250
Lodi, CA 95242
Phone (209) 334-2224

1106 Walnut St
Ste 110
Sn Luis Obisp, CA 93401
Phone (805) 788-0805

408 Higuera St
Ste 200
Sn Luis Obisp, CA 93401

1716 W Hammer Ln
Stockton, CA 95209
Phone (204) 473-2383

4343 Pacific Ave
Ste B1
Stockton, CA 95207
Phone (209) 425-4071

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1315612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1710269246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 HIGUERA ST STE 200",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934016135",
            "telephone_number": "805-788-0805",
            "fax_number": "805-788-0845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 PACIFIC AVE STE B1",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952077664",
            "telephone_number": "209-425-4071",
            "fax_number": "209-451-5687"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2401 W Turner Rd",
            "address_2": "Suite 250",
            "address_purpose": "LOCATION",
            "city": "Lodi",
            "state": "CA",
            "postal_code": "952422182",
            "country_code": "US",
            "telephone_number": "209-334-2224",
            "fax_number": "209-334-2225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATTS",
        "first_name": "EMILY",
        "middle_name": "L",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-10",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT34560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "ENESCU",
            "middle_name": "L",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.