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General NPI Number Information
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NPI Number | 1497593602
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Entity Type | Organization
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Legal Business Name | SHEPARDSON PHYSICAL THERAPY CORPORATION
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Dates
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Enumeration Date | 07/20/2024
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 1314 LINCOLN AVE STE 1F
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City | SAN JOSE
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State | CA
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Zip | 95125-3012
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Country | US
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Telephone | 831-999-0880
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Fax | 833-435-3990
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Provider Business Mailing Address
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Address Line | 952 KENNEDY DR APT B
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City | CAPITOLA
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State | CA
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Zip | 95010-2372
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Country | US
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Telephone | 831-999-0880
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Fax | 833-435-3990
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Authorized Official
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Title or Position | DOCTOR OF PHYSICAL THERAPY
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Name | JASON OLIVER SHEPARDSON
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Credential | DPT, PT
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Telephone | 831-999-0880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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