NPIMap

Organization Active NPI

San Joaquin County CCS

Doing business as Washington Mtu

  • Pediatric Physical Therapist
  • Lodi, CA
National Provider Identifier
1902991201
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
Legal business name
SAN JOAQUIN COUNTY CCS
Doing business as
Washington Mtu
Practice address
825 W Lockeford St
Lodi, CA 95240-1633
Phone
(209) 331-7471
NPI assigned
Oct 3, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Armando Valerio, PT,DPT
Title
MTP Manager
Phone
(209) 953-3617

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2251P0200X Primary

Addresses

Primary practice location

825 W Lockeford St
Lodi, CA 95240-1633

Mailing address

PO Box 2009
Stockton, CA 95201-2009
Phone (209) 331-7471

Other identifiers 1

IdentifierTypeStateIssuer
CCS00004FMedicaidCA

Other names 1

  • WASHINGTON MTU Doing business as

National Provider Directory

National Provider Directory
Tax ID family
County of San Joaquin94 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 17

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 17

Locations

825 W Lockeford St
Lodi, CA 95240
Phone (209) 331-7471

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902991201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2009",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952012009",
            "telephone_number": "209-331-7471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 W LOCKEFORD ST",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952401633",
            "telephone_number": "209-331-7471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN JOAQUIN COUNTY CCS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VALERIO",
        "authorized_official_first_name": "ARMANDO",
        "authorized_official_title_or_position": "MTP MANAGER",
        "authorized_official_telephone_number": "209-953-3617",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT,DPT"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CCS00004F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WASHINGTON MTU",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lodi, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.