Provider Demographics
NPI:1023345287
Name:SLEIGHT, JILL L (ATC)
Entity type:Individual
Prefix:MS
First Name:JILL
Middle Name:L
Last Name:SLEIGHT
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 VENETIA DR
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-3646
Mailing Address - Country:US
Mailing Address - Phone:310-567-7026
Mailing Address - Fax:310-726-0752
Practice Address - Street 1:280 VENETIA DR
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90803-3646
Practice Address - Country:US
Practice Address - Phone:310-567-7026
Practice Address - Fax:310-726-0752
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-09
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer