Provider Demographics
NPI:1982295663
Name:AUBREY, JAMES AKIRA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:AKIRA
Last Name:AUBREY
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 N LOS ROBLES AVE APT 5
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91104-2139
Mailing Address - Country:US
Mailing Address - Phone:408-309-7237
Mailing Address - Fax:
Practice Address - Street 1:12555 LAKEWOOD BLVD STE F
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242-2771
Practice Address - Country:US
Practice Address - Phone:562-923-4704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA299371225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist