Healthcare Provider Details

I. General information

NPI: 1821946195
Provider Name (Legal Business Name): JAN ERIK PARIS PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2026
Last Update Date: 03/20/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1823 SHAW AVE STE 101
CLOVIS CA
93611-4064
US

IV. Provider business mailing address

1823 SHAW AVE STE 101
CLOVIS CA
93611-4064
US

V. Phone/Fax

Practice location:
  • Phone: 559-298-9120
  • Fax:
Mailing address:
  • Phone: 559-298-9120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number17137
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: