Healthcare Provider Details

I. General information

NPI: 1669305660
Provider Name (Legal Business Name): JOSHUA GARRETT PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11225 TAMPA AVE
NORTHRIDGE CA
91326-1610
US

IV. Provider business mailing address

25115 AVENUE STANFORD STE B215
VALENCIA CA
91355-1290
US

V. Phone/Fax

Practice location:
  • Phone: 818-363-9970
  • Fax: 818-363-9980
Mailing address:
  • Phone: 661-250-9940
  • Fax: 661-250-9959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number54426
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: