Provider Demographics
NPI:1932112141
Name:HARBAND, JEFFREY F (PT)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:F
Last Name:HARBAND
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 1:19 VIA CAPISTRANO
Mailing Address - Street 2:
Mailing Address - City:TIBURON
Mailing Address - State:CA
Mailing Address - Zip Code:94920-2030
Mailing Address - Country:US
Mailing Address - Phone:415-309-4012
Mailing Address - Fax:
Practice Address - Street 1:1 BLACKFIELD DR
Practice Address - Street 2:
Practice Address - City:TIBURON
Practice Address - State:CA
Practice Address - Zip Code:94920-2053
Practice Address - Country:US
Practice Address - Phone:415-309-4012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 200572251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00378773OtherRAILROAD MEDICARE
CA0PT200570Medicare PIN