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NPI Code Detail

MEDICARE: ADAM WEAVER

MEDICARE: ADAM WEAVER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramCA
2101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1750953584
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADAM WEAVER
Provider Business Mailing Address
First Line : 11027 BURBANK BLVD
Second Line :
City : NORTH HOLLYWOOD
State : CA
Zip : 91601-2431
Country : US
Telephone Number : 818-985-8323
Fax Number :
Provider Business Practice Location Address
First Line : 11027 BURBANK BLVD
Second Line :
City : NORTH HOLLYWOOD
State : CA
Zip : 91601-2431
Country : US
Telephone Number : 818-985-8323
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2021
Last Update Date : 12/10/2025

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Directions to “ ADAM WEAVER ” Practice Location

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