Provider Demographics
NPI:1053720508
Name:CAREY, JOSHUA (MS, ATC, PES)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:CAREY
Suffix:
Gender:M
Credentials:MS, ATC, PES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3905 CARMEL WAY
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94578-4201
Mailing Address - Country:US
Mailing Address - Phone:510-301-8344
Mailing Address - Fax:
Practice Address - Street 1:3905 CARMEL WAY
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94578-4201
Practice Address - Country:US
Practice Address - Phone:510-301-8344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-08
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer