JAKE DANIEL VAN WEEZEP NPI 1720669393

NPI Information

NPI: 1720669393
Provider Name: JAKE DANIEL VAN WEEZEP
Classification: General Practice - 208D00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
101 BODIN CIR
FAIRFIELD, CA
ZIP 94535
Phone: (707) 423-3048
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Jake Daniel Van Weezep is a general practice in Fairfield, CA. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee Jake Daniel Van Weezep NPI is 1720669393. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

101 BODIN CIR
FAIRFIELD, CA
ZIP 94535-809
Phone: (707) 423-3048

The NPI 1720669393 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/15/2021 and was last updated on 8/3/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	390200000X	Student in an Organized Health Care Education/Training Program				No
2	208D00000X	General Practice		02006978A	INDIANA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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