Healthcare Provider Details

I. General information

NPI: 1306775853
Provider Name (Legal Business Name): JOSE ALFREDO MOZQUEDA SALDANA DOCTOR OF PHYSICAL T
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 W SANTA ANA AVE
CLOVIS CA
93612-3331
US

IV. Provider business mailing address

801 W SANTA ANA AVE
CLOVIS CA
93612-3331
US

V. Phone/Fax

Practice location:
  • Phone: 559-394-0683
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number308568
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: