Provider Demographics
NPI:1912008996
Name:MYERS, JASON ROBERT (PT)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:ROBERT
Last Name:MYERS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 ALAMEDA AVE
Mailing Address - Street 2:STE. B
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-4024
Mailing Address - Country:US
Mailing Address - Phone:831-757-1900
Mailing Address - Fax:831-757-1010
Practice Address - Street 1:515 ALAMEDA AVE
Practice Address - Street 2:STE. B
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4024
Practice Address - Country:US
Practice Address - Phone:831-757-1900
Practice Address - Fax:831-757-1010
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT239232251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PT239231Medicare PIN