Provider Demographics
NPI:1255696514
Name:BAUMANN, JOHN STUART (PT)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:STUART
Last Name:BAUMANN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:652 CARDINAL RIDGE LN UNIT C
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-7114
Mailing Address - Country:US
Mailing Address - Phone:805-416-6081
Mailing Address - Fax:
Practice Address - Street 1:652 CARDINAL RIDGE LN UNIT C
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-7114
Practice Address - Country:US
Practice Address - Phone:805-416-6081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-11
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT7716225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist