MEDICARE: MR. DAVID JOHN JEFFRIES C.O.

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
1	222Z00000X	Orthotist
2	224P00000X	Prosthetist

General Provider Information

NPI Number	:	1962714865
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID JOHN JEFFRIES C.O.

Provider Business Mailing Address
First Line	:	1435 20TH ST
Second Line	:
City	:	LAKEPORT
State	:	CA
Zip	:	95453-3048
Country	:	US
Telephone Number	:	707-349-9484
Fax Number	:

Provider Business Practice Location Address
First Line	:	4847 OLD REDWOOD HWY
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95403-1415
Country	:	US
Telephone Number	:	707-528-9808
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2010
Last Update Date	:	03/04/2014

Similar Medicare Providers

1659366003 — SIERRA ORTHOPEDIC LABORATORY, INC.
Practice Location Address:

4847 OLD REDWOOD HWY
SANTA ROSA, CA
95403-1415

Practice Phone: 707-528-9808
Practice Fax: 707-528-9818

1427112408 — DANIELA DE VASQUES BAKER PSYD
Practice Location Address:

4865 OLD REDWOOD HWY STE 102
SANTA ROSA, CA
95403-1415

Practice Phone: 415-254-3797
Practice Fax:

1205275690 — THRIVE CENTER FOR BIRTH & FAMILY WELLNESS, INC
Practice Location Address:

4859 OLD REDWOOD HWY
SANTA ROSA, CA
95403-1415

Practice Phone: 707-387-2088
Practice Fax: 707-324-5582

1063899904 — THRIVE BIRTH CENTER INC
Practice Location Address:

4859 OLD REDWOOD HWY
SANTA ROSA, CA
95403-1415

Practice Phone: 707-387-2088
Practice Fax:

1730550534 — EDWARD FERRERO
Practice Location Address:

4865 OLD REDWOOD HWY STE 102
SANTA ROSA, CA
95403-1415

Practice Phone: 707-890-6541
Practice Fax: 888-528-7464

1093582421 — JAMIE TENNILLE WEAVER LICENSED MIDWIFE
Practice Location Address:

4859 OLD REDWOOD HWY
SANTA ROSA, CA
95403-1415

Practice Phone: 740-590-9449
Practice Fax:

Directions to “ MR. DAVID JOHN JEFFRIES C.O.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.