Provider Demographics
NPI:1346315942
Name:FERMO, JIM DARRYL (PHD)
Entity Type:Individual
Prefix:
First Name:JIM
Middle Name:DARRYL
Last Name:FERMO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:JIM
Other - Middle Name:D
Other - Last Name:FERMO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:19934 LUBAO PL
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-1818
Mailing Address - Country:US
Mailing Address - Phone:818-326-9499
Mailing Address - Fax:818-368-7670
Practice Address - Street 1:19934 LUBAO PL
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-1818
Practice Address - Country:US
Practice Address - Phone:818-326-9499
Practice Address - Fax:818-368-7670
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2019-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist