Provider Demographics
NPI:1982492831
Name:VAUGHAN, JAMES TIMOTHY (DPT)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:TIMOTHY
Last Name:VAUGHAN
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 SAN FERNANDO DR
Mailing Address - Street 2:
Mailing Address - City:PASO ROBLES
Mailing Address - State:CA
Mailing Address - Zip Code:93446-3511
Mailing Address - Country:US
Mailing Address - Phone:805-952-3862
Mailing Address - Fax:
Practice Address - Street 1:265 SAN FERNANDO DR
Practice Address - Street 2:
Practice Address - City:PASO ROBLES
Practice Address - State:CA
Practice Address - Zip Code:93446-3511
Practice Address - Country:US
Practice Address - Phone:805-952-3862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA304710225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist