Healthcare Provider Details

I. General information

NPI: 1174433734
Provider Name (Legal Business Name): JEREMY DANIEL AZPARREN MPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3603 N WELLSLEY ST
VISALIA CA
93291-6558
US

IV. Provider business mailing address

3603 N WELLSLEY ST
VISALIA CA
93291-6558
US

V. Phone/Fax

Practice location:
  • Phone: 559-589-2650
  • Fax: 559-589-9611
Mailing address:
  • Phone: 559-589-2650
  • Fax: 559-589-9611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number33550
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: