=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033023817
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JESTON BLAIR PARAMEDIC
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/30/2026
-----------------------------------------------------
Last Update Date | 09/30/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6 SMITH BROTHERS CT
-----------------------------------------------------
City | CHICO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95926-5212
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-588-4815
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6 SMITH BROTHERS CT
-----------------------------------------------------
City | CHICO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95926-5212
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-588-4815
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 146L00000X
-----------------------------------------------------
Taxonomy Name | Paramedic
-----------------------------------------------------
License Number | P29834
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------