Healthcare Provider Details

I. General information

NPI: 1316010523
Provider Name (Legal Business Name): PRECISION HEALTH AND REHABILITATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 06/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9000 SOQUEL AVE SUITE 103
SANTA CRUZ CA
95062-2097
US

IV. Provider business mailing address

9000 SOQUEL AVE SUITE 103
SANTA CRUZ CA
95062-2097
US

V. Phone/Fax

Practice location:
  • Phone: 831-464-8200
  • Fax: 831-477-2924
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT20895
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT181
License Number StateCA

VIII. Authorized Official

Name: JAMES VEGHER
Title or Position: OWNER
Credential: PT
Phone: 831-464-8200