Provider Demographics
NPI:1851332969
Name:WEINSTEIN, DEBORAH (PT)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:WEINSTEIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22842 MANTANZA DR
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-2736
Mailing Address - Country:US
Mailing Address - Phone:949-370-4061
Mailing Address - Fax:949-273-3325
Practice Address - Street 1:22842 MANTANZA DR
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-2736
Practice Address - Country:US
Practice Address - Phone:949-370-4061
Practice Address - Fax:949-273-3325
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3427225100000X
CAPT7021225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT0070210OtherBS PROV NUMBER
CAFR375ZMedicare PIN