Provider Demographics
NPI:1497220990
Name:YANGCO, JOSEPH LEGASPI (PT)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:LEGASPI
Last Name:YANGCO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8711 WINTERFEST WAY
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-1295
Mailing Address - Country:US
Mailing Address - Phone:415-244-7744
Mailing Address - Fax:
Practice Address - Street 1:442 E HAMPTON ST
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95204-5519
Practice Address - Country:US
Practice Address - Phone:209-466-0456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-10
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36295225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist