Individual provider Active NPI

Clifford James Leduc, P.T.

  • Orthopedic Physical Therapist
  • Penn Valley, CA
National Provider Identifier
1902839467
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT12819 Issued in CA
Practice address
11392 Pleasant Valley Rd
Penn Valley, CA 95946-9001
Phone
(530) 432-9660
Fax
(530) 432-9663
NPI assigned
Jul 8, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT12819 CA Primary

Addresses

Primary practice location

11392 Pleasant Valley Rd
Penn Valley, CA 95946-9001

Mailing address

11392 Pleasant Valley Rd
Penn Valley, CA 95946-9001
Phone (530) 432-9660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT12819CAMDOrthopedic Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902839467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11392 PLEASANT VALLEY RD",
            "city": "PENN VALLEY",
            "state": "CA",
            "postal_code": "959469001",
            "telephone_number": "530-432-9660",
            "fax_number": "530-432-9663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11392 PLEASANT VALLEY RD",
            "city": "PENN VALLEY",
            "state": "CA",
            "postal_code": "959469001",
            "telephone_number": "530-432-9660",
            "fax_number": "530-432-9663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDUC",
        "first_name": "CLIFFORD",
        "middle_name": "JAMES",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT12819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Penn Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.