Provider Demographics
NPI:1760286694
Name:WEISSMANN, BRIAN (CMT)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:WEISSMANN
Suffix:
Gender:
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 SOUTH ALAMEDA LANE UNIT A
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92672-5305
Mailing Address - Country:US
Mailing Address - Phone:949-701-5453
Mailing Address - Fax:
Practice Address - Street 1:105 SOUTH ALAMEDA LANE UNIT A
Practice Address - Street 2:
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92672-5305
Practice Address - Country:US
Practice Address - Phone:949-701-5453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA99035225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist