Provider Demographics
NPI:1437786647
Name:PADILLA, JOSHUA ISAHI SEBASTIAN
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:ISAHI SEBASTIAN
Last Name:PADILLA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3338 ORKNEY RD
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-2908
Mailing Address - Country:US
Mailing Address - Phone:915-491-3904
Mailing Address - Fax:
Practice Address - Street 1:821 N NELLIS BLVD STE 130
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89110-5387
Practice Address - Country:US
Practice Address - Phone:702-452-4563
Practice Address - Fax:702-452-6704
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX120631225X00000X
NV2987225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist