Provider Demographics
NPI:1508338245
Name:TATSUNO, JOSHUA (DPT)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:TATSUNO
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:993 SELBY LN
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95127-1151
Mailing Address - Country:US
Mailing Address - Phone:408-493-3669
Mailing Address - Fax:
Practice Address - Street 1:1375 BLOSSOM HILL RD STE 33
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95118-3825
Practice Address - Country:US
Practice Address - Phone:408-784-7167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-19
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT2959302251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports