Nicholas C Anderson, PTA
Individual provider Active NPI Physical Therapy Assistant · Patterson, CA
NPI 1962041301 · NPPES record last updated Jan 2, 2020
Key facts
- NPI
- 1962041301
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- PTA50433 (CA)
- Practice address
- 1700 Keystone Pacific Pkwy
Patterson, CA 95363-8874 - Phone
- (209) 895-4206
- NPI assigned
- Jan 2, 2020
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|
| PTA50433 | CA | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA50433 | CA | Yes |
Addresses
Primary practice location
1700 Keystone Pacific Pkwy
Patterson, CA 95363-8874
Mailing address
1518 Coffee Rd
Modesto, CA 95355-3164
Phone (209) 622-4387
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PTA50433 | Other | CA | PTA |
Other providers in Patterson, CA
- A Wahid MD Inc a Professional Medical Corporation
- Ali Abdul Wahid
- Alicia Marie Agundez
- Kent Walton Allen
- Maria Alicia Anaya
- Anthony Nguyen, OD Inc
- Cler Vicentina Aquillas
- Vanessa Araisa-Herrera
- Archive Health Medical PC
- Deanna H Arroyo
All providers in Patterson, 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 Jan 2, 2020. 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.