=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538041330
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | REHABDIRECT INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/23/2025
-----------------------------------------------------
Last Update Date | 09/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 368 ROSEBROOK DR
-----------------------------------------------------
City | BAY POINT
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94565-7630
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 651-795-8779
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 368 ROSEBROOK DR
-----------------------------------------------------
City | BAY POINT
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94565-7630
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 651-795-8779
-----------------------------------------------------
Fax | 925-664-0346
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO & PHYSICAL THERAPIST
-----------------------------------------------------
Name | DR. JAYMESON ANDERSON
-----------------------------------------------------
Credential | DPT
-----------------------------------------------------
Telephone | 651-795-8779
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------