Provider Demographics
NPI:1730764127
Name:NAVARRO, JOSEPH RIGOBERTO JR
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:RIGOBERTO
Last Name:NAVARRO
Suffix:JR
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 1:13386 MARENGO RD
Mailing Address - Street 2:
Mailing Address - City:GALT
Mailing Address - State:CA
Mailing Address - Zip Code:95632-8429
Mailing Address - Country:US
Mailing Address - Phone:209-922-7249
Mailing Address - Fax:
Practice Address - Street 1:13386 MARENGO RD
Practice Address - Street 2:
Practice Address - City:GALT
Practice Address - State:CA
Practice Address - Zip Code:95632-8429
Practice Address - Country:US
Practice Address - Phone:209-922-7249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-16
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1111Medicaid