1578897815 NPI number — JOAN MARLENE ARIETA

Table of content: (NPI 1578897815)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578897815 NPI number — JOAN MARLENE ARIETA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JOAN MARLENE ARIETA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ALHAMBRA VALLEY PHYSICAL THERAPY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1578897815
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/15/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1923 OAK PARK BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PLEASANT HILL
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94523-4601
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
925-930-0545
Provider Business Mailing Address Fax Number:
925-930-0717

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1923 OAK PARK BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLEASANT HILL
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94523-4601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
925-930-0545
Provider Business Practice Location Address Fax Number:
925-930-0717
Provider Enumeration Date:
09/18/2009

Additional Information

Authorized Official

Authorized Official Last Name:
ARIETA
Authorized Official First Name:
JOAN
Authorized Official Middle Name:
MARLENE
Authorized Official Title or Position:
OWNER/PHYSICAL THERAPIST
Authorized Official Telephone Number:
925-930-0545

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  PT 7431 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 225100000X , with the licence number: PT 33235 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225200000X , with the licence number: AT 8707 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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