Healthcare Provider Details

I. General information

NPI: 1649051681
Provider Name (Legal Business Name): JOSHUA PAUL AMADOR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2023
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6765 GREEN VALLEY RD
PLACERVILLE CA
95667-8984
US

IV. Provider business mailing address

6765 GREEN VALLEY RD
PLACERVILLE CA
95667-8984
US

V. Phone/Fax

Practice location:
  • Phone: 530-622-5551
  • Fax: 530-622-5800
Mailing address:
  • Phone: 530-622-5551
  • Fax: 530-622-5800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: