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NPI Code Detail

MEDICARE: MARIA FELINA H. CALVERO PTA

MEDICARE: MARIA FELINA H. CALVERO PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant8604CA

General Provider Information

NPI Number : 1578030656
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIA FELINA H. CALVERO PTA
Provider Business Mailing Address
First Line : 6501 OSCAR CIR
Second Line :
City : ELK GROVE
State : CA
Zip : 95757-5985
Country : US
Telephone Number : 909-994-7362
Fax Number :
Provider Business Practice Location Address
First Line : 442 E HAMPTON ST
Second Line :
City : STOCKTON
State : CA
Zip : 95204-5519
Country : US
Telephone Number : 209-466-0456
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2018
Last Update Date : 10/27/2018

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