Allen Oliver, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

AT6373 Issued in CA

Practice address

1335 Coffee Rd #200
Modesto, CA 95355

Phone

(209) 576-1946

Fax

(209) 576-0072

NPI assigned

Jul 2, 2014

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

Practice roles

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

• Golden Bear Physical Therapy

  • Physical Therapy Assistant
  • Modesto, CA
  • NPI 1841669710
  NPD (past)
• Golden Bear Physical Therapy Sports Injury Center, Inc

  • Physical Therapy Clinic/Center
  • Modesto, CA
  • NPI 1811084676
  NPD (past)

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

{
    "created_epoch": "1404259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404259200000",
    "number": "1740696459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4318 SPYRES WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "95356",
            "telephone_number": "209-576-0710",
            "fax_number": "209-576-0913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1335 COFFEE RD #200",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "95355",
            "telephone_number": "209-576-1946",
            "fax_number": "209-576-0072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "ALLEN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-02",
        "last_updated": "2014-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "AT6373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Arthur Oliphant, ATC
• Fernando Olivares
• Vilma Olivares
• Gabriella Zuniga Olivas
• Mickensey Lynn Oliveira
• Isabella Oliver
• Maliza Cahee Oliver, DDS
• Martin Oliver III, CADC-CAS
• Karina Olivera
• Benjamin Ollar

• Physical Therapy Assistant in Modesto, CA
• Providers in Modesto, 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 Jul 2, 2014; 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.