Elena J Juarez-Wilson, PTA
Individual provider Active NPI Physical Therapy Assistant · Exeter, CA
NPI 1851726558 · NPPES record last updated Sep 12, 2013
Key facts
- NPI
- 1851726558
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- AT10027 (CA)
- Practice address
- 511 W Visalia Rd
Exeter, CA 93221-1019 - Phone
- (559) 592-7117
- Fax
- (559) 592-7112
- NPI assigned
- Sep 12, 2013
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT10027 | CA | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | AT10027 | CA | Yes |
Addresses
Primary practice location
511 W Visalia Rd
Exeter, CA 93221-1019
Mailing address
511 W Visalia Rd
Exeter, CA 93221-1019
Phone (559) 592-7117
Other providers in Exeter, CA
- Torey Sue Ivanic
- Lauren M Ivanoff
- Roberto Jaramillo
- Marlaine Cheryl Jensen
- Corey J Jones
- Alexis Kapheim
- Aaron Josef Kasser
- Simranpreet Kaur
- Kaweah Delta Health Care District
- Kealani Sine MD Inc
All providers in Exeter, CA · Physical Therapy Assistant in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 12, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.