Provider Demographics
NPI:1982778007
Name:CUMMINS, JOANNE FERDA (PT)
Entity Type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:FERDA
Last Name:CUMMINS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6061 N FIRST ST
Mailing Address - Street 2:STE 104
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-5470
Mailing Address - Country:US
Mailing Address - Phone:559-438-1245
Mailing Address - Fax:
Practice Address - Street 1:6061 N FIRST ST
Practice Address - Street 2:STE 104
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5470
Practice Address - Country:US
Practice Address - Phone:559-438-1245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT18745225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PT187451Medicare PIN
CA0PT179171Medicare UPIN