Provider Demographics
NPI:1982998217
Name:TRAVIS, JOSHUA A (DO)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:A
Last Name:TRAVIS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3335 PLACER ST STE 207
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-2364
Mailing Address - Country:US
Mailing Address - Phone:530-941-1017
Mailing Address - Fax:530-241-1095
Practice Address - Street 1:448 REDCLIFF DR STE 120
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-0159
Practice Address - Country:US
Practice Address - Phone:530-941-1017
Practice Address - Fax:530-241-1095
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-03
Last Update Date:2018-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A13449207R00000X, 208M00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine