Jesus-Fernando Silva Tabarez, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

AT11057 Issued in CA

Practice address

1700 Coffee Rd
Modesto, CA 95355-2803

Phone

(209) 526-4500

Fax

(209) 572-7278

NPI assigned

Nov 29, 2023

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

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

{
    "created_epoch": "1701216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1861268070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552803",
            "telephone_number": "209-526-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552803",
            "telephone_number": "209-526-4500",
            "fax_number": "209-572-7278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABAREZ",
        "first_name": "JESUS-FERNANDO",
        "middle_name": "SILVA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-29",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "AT11057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Synergy Health Companies, Inc.
• Crystal Synstad
• Simon Szeto
• Tracy Tabalon
• Ehsan Tabaraee, M.D.
• Cheska Mafaye Rafols Tablang, MD
• Marcella Ann Tackett, ACSW
• Anessia Tacla
• Charlotte June Tacy, OT
• Julienne Tadena

• 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 Nov 29, 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.