MR. BRIAN GONZALES PUCKETT (NPI# 1912484205) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912484205 |
| Entity Type | Individual |
| Full Name | MR. BRIAN GONZALES PUCKETT |
| Practice Address |
426 N Imperial Ave El Centro CA 92243-2329 |
| Mailing Address |
3760 Convoy St Ste 101 San Diego CA 92111-3743 |
| Practice Telephone | 7605928148 |
| Practice Fax Number | 7608415556 |
| Mailing Telephone | 8582641434 |
| Mailing Fax Number | 8587510901 |
| Enumeration Date | 2018-07-19 |
| Last Update Date | 2020-01-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208100000X | Physical Medicine & Rehabilitation | 34600 | CA | Allopathic & Osteopathic Physicians |
| Y | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
426 N IMPERIAL AVE |
| City | EL CENTRO |
| State | CA |
| Zip Code | 92243-2329 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912157637 | Douglas Dean Wisdom | Physical Therapist | 426 N Imperial Ave, El Centro, CA 92243-2329 | 2008-09-30 |
| 1396353777 | Drue Alan Bosco | Physical Therapist | 426 N Imperial Ave, El Centro, CA 92243-2329 | 2020-07-21 |
| 1053943720 | Dustin John Andrew Miller | Physical Therapist | 426 N Imperial Ave, El Centro, CA 92243-2329 | 2020-02-10 |
| 1770958621 | Jaclyn Michaela Perakis | Physical Therapist | 426 N Imperial Ave, El Centro, CA 92243-2329 | 2015-12-03 |
| 1780073718 | Wisdom Physical Therapy, Inc. | Physical Therapist | 426 N Imperial Ave, El Centro, CA 92243-2329 | 2015-01-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437756228 | Kale Burket | Physician Assistant | Bldg 523, S 8th St, El Centro, CA 92243 | 2020-10-05 |
| 1346856671 | Ana Lilia Solorio | Health Educator | 1415 Ross Ave., El Centro, CA 92243 | 2020-09-22 |
| 1467073775 | Mabel Janet Castro-ley | Counselor | 22 N 8th St., El Centro, CA 92243 | 2020-04-28 |
| 1831723030 | Guadalupe Heredia | Registered Nurse | 1415 Ross Ave El Centro Ca, El Centro, El Centro, CA 92243 | 2020-02-26 |
| 1851948061 | Hamlet Khachatryan Dds, Inc. | Dentist | 1698 Cruickshank Drive, Suite B, El Centro, CA 92243 | 2019-08-22 |
| 1104478924 | Courtney Barker | Occupational Therapist | 1161 Main St., El Centro, CA 92243 | 2019-07-11 |
| 1891350997 | Amy Nguyen Dao | Nurse Practitioner | 852 Danenberg Drive, El Centro, CA 92243 | 2019-05-03 |
| 1538723622 | Patrick H Dao | Nurse Practitioner | 852 Danenberg Dr., El Centro, CA 92243 | 2019-04-24 |
| 1114494861 | Alba Care Mental Health Serrvices | Counselor | 1498 Main Street, El Centro, CA 92243 | 2018-10-31 |
| 1922503085 | Joanne P. Goode | Nurse Practitioner | El Centro Health Clinic, 651 Wake Avenue, El Centro, CA 92243 | 2018-03-29 |
| Find all providers in zip 92243 | ||||
| Taxonomy Code | 225100000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT’s assess joint motion, muscle strength and endurance, function of heart and lungs, and performance of activities required in daily living, among other responsibilities. Treatment includes therapeutic exercises, cardiovascular endurance training, and training in activities of daily living. (2) A physical therapist is a person qualified by an accredited program in physical therapy, licensed by the state, and practicing within the scope of that license. Physical therapists treat disease, injury, or loss of a bodily part by physical means, such as the application of light, heat, cold, water, electricity, massage and exercise. They develop treatment plans based upon each patient’s strengths, weaknesses, range of motion and ability to function. (3) A health professional who specializes in physical therapy- the health care field concerned primarily with the treatment of disorders with physical agents and methods, such as massage, manipulation, therapeutic exercises, cold, heat (including short-wave, microwave, and ultrasonic diathermy), hydrotherapy, electric stimulation and light to assist in rehabilitating patients and in restoring normal function after an illness or injury. |
| Notes: Source: (1) APTA Guidelines for Physical Therapy Claims Review, American Physical Therapy Association. (3) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497187124 | Andrea Montijo | Physical Therapist | 561 West Main Street, El Centro, CA 92243 | 2013-08-05 |
| 1770923781 | Becky Mcquain | Physical Therapist | 1098 Palmview Ave, El Centro, CA 92243-9148 | 2013-07-05 |
| 1558508713 | Andrea Montijo | Physical Therapist | 561 W Main St, El Centro, CA 92243-7917 | 2009-01-09 |
| 1912157637 | Douglas Dean Wisdom | Physical Therapist | 426 N Imperial Ave, El Centro, CA 92243-2329 | 2008-09-30 |
| 1295798676 | Russell Dial | Physical Therapist | 1611 W Main St, El Centro, CA 92243-2212 | 2006-04-07 |
| 1194727222 | Ann-marie Wurzbach | Physical Therapist | 428 N Imperial Ave, El Centro, CA 92243-2329 | 2005-06-01 |
| 1396353777 | Drue Alan Bosco | Physical Therapist | 426 N Imperial Ave, El Centro, CA 92243-2329 | 2020-07-21 |
| 1053943720 | Dustin John Andrew Miller | Physical Therapist | 426 N Imperial Ave, El Centro, CA 92243-2329 | 2020-02-10 |
| 1154847820 | Amisha Kishen Lala | Physical Therapist | 1611 W Main St, El Centro, CA 92243-2212 | 2017-08-15 |
| 1649633520 | Cody Cooper | Physical Therapist | 1611 W Main St, El Centro, CA 92243-2212 | 2016-03-30 |
| Find all providers in EL CENTRO | ||||
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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.