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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