Organization
SAN JOAQUIN COUNTY CCS
Active
Organization
SAN JOAQUIN COUNTY CCS
Active
Other names
WASHINGTON MTU
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ARMANDO VALERIO PT,DPT (MTP MANAGER)
(209) 953-3617
Entity
Organization
Contact information
Practice address
825 W LOCKEFORD ST, LODI, CA 95240-1633
(209) 331-7471
Mailing address
PO BOX 2009, STOCKTON, CA 95201-2009
(209) 331-7471
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CCS00004F
—
CA
Enumeration date
10/03/2006
Last updated
08/22/2020
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