MEDICARE: JOHN J VELASCO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	373H00000X	Day Training/Habilitation Specialist
2	225400000X	Rehabilitation Practitioner

General Provider Information

NPI Number	:	1780713396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN J VELASCO

Provider Business Mailing Address
First Line	:	2550 W CLINTON AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93705-4206
Country	:	US
Telephone Number	:	559-264-7521
Fax Number	:

Provider Business Practice Location Address
First Line	:	2550 W CLINTON AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93705-4206
Country	:	US
Telephone Number	:	559-264-7521
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2007
Last Update Date	:	07/08/2025

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