Provider Demographics
NPI:1538136767
Name:WEAST, JEFFREY S (MPT)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:S
Last Name:WEAST
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 NOTRE DAME BLVD
Mailing Address - Street 2:STE 120
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928
Mailing Address - Country:US
Mailing Address - Phone:530-898-9850
Mailing Address - Fax:530-989-9860
Practice Address - Street 1:2000 NOTRE DAME BLVD
Practice Address - Street 2:STE 120
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928
Practice Address - Country:US
Practice Address - Phone:530-898-9850
Practice Address - Fax:530-989-9860
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23641225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PT236412Medicare ID - Type Unspecified