Provider Demographics
NPI:1932653342
Name:BUUS, JESSICA ANN LEIMKUHLER (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:ANN LEIMKUHLER
Last Name:BUUS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:LEIMKUHLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6832 HAZARD AVE
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-4914
Mailing Address - Country:US
Mailing Address - Phone:714-747-8947
Mailing Address - Fax:
Practice Address - Street 1:17332 VON KARMAN AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-6242
Practice Address - Country:US
Practice Address - Phone:949-861-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-15
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA291626225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA291626OtherSTATE LICENSE