Provider Demographics
NPI:1295992006
Name:FERINE, JASON JOHN (MSPT)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:JOHN
Last Name:FERINE
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 WESTWOOD BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-2045
Mailing Address - Country:US
Mailing Address - Phone:424-365-2083
Mailing Address - Fax:424-325-5225
Practice Address - Street 1:2300 WESTWOOD BLVD STE 101
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-2045
Practice Address - Country:US
Practice Address - Phone:424-365-2083
Practice Address - Fax:424-325-5225
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-20
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029361-1225100000X
TN8295225100000X
CAPT 35755225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN8295OtherPT LICENSE
Q5E8GQ39M1Medicare Oscar/Certification
TN8295OtherPT LICENSE