MR. PHILIP JOHN BRERETON (NPI# 1033565544) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033565544 |
| Entity Type | Individual |
| Full Name | MR. PHILIP JOHN BRERETON |
| Credential | CO |
| Practice Address |
466 E Harding Way Stockton CA 95204 |
| Mailing Address |
961 Matley Ln Ste 100 Reno NV 89502-2100 |
| Practice Telephone | 2094662546 |
| Mailing Telephone | 7753238118 |
| Mailing Fax Number | 7753231234 |
| Enumeration Date | 2016-05-13 |
| Last Update Date | 2016-05-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 222Z00000X | Orthotist | C52250 | NV | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
466 E HARDING WAY |
| City | STOCKTON |
| State | CA |
| Zip Code | 95204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962027524 | Kariem Abdelwahed | Licensed Vocational Nurse | 1630 N. Edison St Stockton Ca, Stockton, CA 95204 | 2020-06-10 |
| 1831730555 | Ronnie C Murray | Counselor | 1947 North California Street, Stockton, CA 95204 | 2019-10-03 |
| 1235614116 | Michelle Ann Horn | Marriage & Family Therapist | 3666 Mission Rd, Stockton, CA 95204 | 2018-09-26 |
| 1356830947 | Stockton Pace | PACE Provider Organization | 582 E. Harding Way, Stockton, CA 95204 | 2018-05-09 |
| 1790228781 | Rebecca Phongsa | Counselor | 1947 North Calfornia Street, Suite B, Stockton, CA 95204 | 2016-11-23 |
| 1700332905 | Serim Kang | Driver | 4222 N Pershing Ave, Suite D2, Stockton, CA 95204 | 2016-08-28 |
| 1932507522 | David Grayson | Counselor | 1621 Brookside Rd, Stockton, CA 95204 | 2014-12-12 |
| 1174934897 | Gurtej Malhi | Internal Medicine | 1901 N California Street, Stockton, CA 95204 | 2014-05-15 |
| 1396156170 | Rajesh Saini | Nurse Practitioner | 1805 N California St. Suite 102, Stockton, CA 95204 | 2014-05-14 |
| 1649680364 | Marc K Massey | Physician Assistant | 1800 N California St, Stockton, Ca, Stockton, CA 95204 | 2014-05-02 |
| Find all providers in zip 95204 | ||||
| Taxonomy Code | 222Z00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Orthotist |
| A health care professional who is specifically educated and trained to manage comprehensive orthotic patient care, including musculoskeletal and neuromuscular anomalies resulting from injuries or disease processes involving the lower extremity, upper extremity or spinal segment/s and positional deformation of the cranium. Orthotists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376736231 | Patrick R Crowley | Orthotist | 1236 N El Dorado St Ste Abc, Stockton, CA 95202-1324 | 2007-08-23 |
| 1013208735 | Jason L Warren | Orthotist | 1236 N El Dorado St Ste Abc, Stockton, CA 95202-1324 | 2011-04-28 |
| 1770899460 | Matthew Legasse | Orthotist | 1236 N El Dorado St Ste Abc, Stockton, CA 95202-1324 | 2010-08-19 |
| 1790974137 | Charles Stockert | Orthotist | 1236 N El Dorado St Ste Abc, Stockton, CA 95202-1324 | 2007-10-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780284851 | Hannah Mckinsey Oltrogge | Orthotist | 1260 S Main St Ste 102, Salinas, CA 93901-2292 | 2020-10-28 |
| 1639789779 | Dynamics Orthotics & Prosthetics, Inc | Orthotist | 2150 N Waterman Ave Ste 301, San Bernardino, CA 92404-4811 | 2020-08-04 |
| 1043833619 | Tim Shride | Orthotist | 3800 Watt Ave Ste 151, Sacramento, CA 95821-2688 | 2020-05-18 |
| 1255964854 | Stephanie Janae Ybarra | Orthotist | 5412 Avenida De Los Robles, Suite 101, Visalia, CA 93291 | 2020-02-21 |
| 1558994129 | Jacy Kay Young | Orthotist | 1247 E Alluvial Ave Ste 112, Fresno, CA 93720-2686 | 2020-02-21 |
| 1851935217 | Timothy James Johnston | Orthotist | 635 Anderson Rd., Suite 18, Davis, CA 95616 | 2019-10-29 |
| 1629628243 | Christian Rae Figueroa | Orthotist | 19845 Lake Chabot Rd Ste 302, Castro Valley, CA 94546-4055 | 2019-09-16 |
| 1710534821 | Alpha Iscandari Sanusi | Orthotist | 1760 Chicago Ave Ste L21, Riverside, CA 92507-2326 | 2019-08-22 |
| 1255998290 | West Coast Dme & Supplies LLC | Orthotist | 8322 Clairemont Mesa Blvd Ste 105, San Diego, CA 92111-1317 | 2019-05-24 |
| 1043876162 | Kadesh Gamall Gayle | Orthotist | 20595 Spring St, Riverside, CA 92507-0128 | 2019-05-14 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.