Provider Demographics
NPI:1699342212
Name:BATTOCCHIO, JAMES MICHAEL (PTA)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:MICHAEL
Last Name:BATTOCCHIO
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1436 S E ST
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93033-3149
Mailing Address - Country:US
Mailing Address - Phone:805-822-8564
Mailing Address - Fax:
Practice Address - Street 1:1436 S E ST
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93033-3149
Practice Address - Country:US
Practice Address - Phone:805-822-8564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAT4091225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAT4091OtherPTA LICENSE