Provider Demographics
NPI:1073572913
Name:SPHAR, WESLEY JAY (ATC)
Entity Type:Individual
Prefix:MR
First Name:WESLEY
Middle Name:JAY
Last Name:SPHAR
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2682 LA RINCONADA PL
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-3708
Mailing Address - Country:US
Mailing Address - Phone:530-224-9420
Mailing Address - Fax:530-224-1095
Practice Address - Street 1:2682 LA RINCONADA PL
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-3708
Practice Address - Country:US
Practice Address - Phone:530-222-3086
Practice Address - Fax:530-224-1095
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-20
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0000804632255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer