| Doctor Name: | JASON AVERILLA |
| NPI Number: | 1932575099 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT, DPT |
| License Number: | PT 42767 |
| Business Practice Address: | 8881 Fletcher Pkwy Ste 385 La Mesa, CA - 919426106 |
| Business Phone Number: | 6194600137 |
| Business Fax Number: | 6194600139 |
| Mailing Address: | 3959 Ruffin Rd Ste J, SAN DIEGO |
| State: | CA |
| Postal Code: | 921231830 |
| Phone Number: | 8582795570 |
| Fax Number: | 8582795303 |
| NPI Enumeration Date: | 08/12/2015 |
| NPI Last Update Date: | 08/13/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT 42767 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |