Healthcare Provider Details

I. General information

NPI: 1336266717
Provider Name (Legal Business Name): GARRETT JAMES YOSHIDA P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 E CAPOVILLA AVE STE 104
LAS VEGAS NV
89119-4332
US

IV. Provider business mailing address

10784 AVENZANO ST
LAS VEGAS NV
89141-3503
US

V. Phone/Fax

Practice location:
  • Phone: 702-896-6393
  • Fax: 702-739-0105
Mailing address:
  • Phone: 702-419-3638
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number1499
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number1499
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: