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General NPI Number Information
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NPI Number | 1184631038
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Entity Type | Individual
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Provider Name | RAYMOND JOHN WEAVER LMFT
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Gender | Male
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Dates
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Enumeration Date | 08/02/2006
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Last Update Date | 04/20/2010
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Provider Practice Location Address
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Address Line | 18023 SKY PARK CIR SUITE G
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City | IRVINE
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State | CA
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Zip | 92614-6521
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Country | US
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Telephone | 714-371-6050
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Fax |
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Provider Business Mailing Address
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Address Line | 18023 SKY PARK CIR SUITE G
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City | IRVINE
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State | CA
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Zip | 92614-6521
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Country | US
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Telephone | 949-939-5112
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 45917
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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