Healthcare Provider Details

I. General information

NPI: 1164364469
Provider Name (Legal Business Name): MR. JOE ALVARES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2026
Last Update Date: 04/07/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3327 M ST
MERCED CA
95348-2705
US

IV. Provider business mailing address

3327 M ST
MERCED CA
95348-2705
US

V. Phone/Fax

Practice location:
  • Phone: 209-722-1030
  • Fax:
Mailing address:
  • Phone: 209-722-1030
  • Fax: 209-722-5408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number52924
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: