Healthcare Provider Details

I. General information

NPI: 1508282328
Provider Name (Legal Business Name): JOSEPH MATTHEW CARINCI PT, DSC, CSCS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2014
Last Update Date: 03/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 J ST
SACRAMENTO CA
95819-3626
US

IV. Provider business mailing address

4001 J ST
SACRAMENTO CA
95819-3626
US

V. Phone/Fax

Practice location:
  • Phone: 916-453-4804
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number18577
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: