Healthcare Provider Details

I. General information

NPI: 1518627009
Provider Name (Legal Business Name): PAULO SITAGATA PT, DPT, FAFS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/23/2021
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3055 FLOYD AVE APT 112
MODESTO CA
95355-7925
US

IV. Provider business mailing address

3055 FLOYD AVE APT 112
MODESTO CA
95355-7925
US

V. Phone/Fax

Practice location:
  • Phone: 818-679-1930
  • Fax:
Mailing address:
  • Phone: 818-679-1930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: