Provider Demographics
NPI:1063236057
Name:URREA, JOSHUA STEPHEN
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:STEPHEN
Last Name:URREA
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:PO BOX 8805
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92375-2005
Mailing Address - Country:US
Mailing Address - Phone:909-503-2939
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 8805
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92375-2005
Practice Address - Country:US
Practice Address - Phone:909-503-2939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant