Healthcare Provider Details

I. General information

NPI: 1083593156
Provider Name (Legal Business Name): JOSHUA MENDOZA PEREZ PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2025
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3825 EL CAMINO REAL
PALO ALTO CA
94306-3324
US

IV. Provider business mailing address

PO BOX 276950
SACRAMENTO CA
95827-6950
US

V. Phone/Fax

Practice location:
  • Phone: 650-565-8090
  • Fax:
Mailing address:
  • Phone: 650-565-8090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number308798
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: