Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Joseph Johnny Provenzano Jr., DO

Individual provider Family Medicine Physician · NPI 1215993738

Joseph Johnny Provenzano Jr., DO is a Family Practice in Modesto, California. Qualified in 1983, 43 years ago. Practices with Sutter Valley Medical Foundation, a 2,464-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
43
Licensed in
CA
In the registry since
2006
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

3612 Dale Rd
Modesto, CA 95356-0500
Phone: (209) 522-0146
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 20A5427 (CA)

Record details

NPI number1215993738
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedApril 24, 2006
Last updated in NPPESJune 11, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 1983 (43 years in practice)
Group practice Sutter Valley Medical Foundation — 2464 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations8 on file with Medicare

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