Starlight Weiderman-Tyrrell, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT37728 Issued in CA

Practice address

3772 Mission Ave
Suite 120
Oceanside, CA 92058-1453

Phone

(760) 630-8400

NPI assigned

Sep 4, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1441324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449532800000",
    "number": "1548638703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3980 LAGO DI GRATA CIR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921308601",
            "telephone_number": "619-990-0543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3772 MISSION AVE",
            "address_2": "SUITE 120",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920581453",
            "telephone_number": "760-630-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIDERMAN-TYRRELL",
        "first_name": "STARLIGHT",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-04",
        "last_updated": "2015-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT37728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shiloh Serene Wecklich, PA-C
• Anthony Weeks
• Joshua Connor Wehn, PA-C
• Destiny Rose Weick
• Ann Weidenbacher, MA, IMFT
• Andrew Weidler
• Nash Devereau Weinberg, PT, DPT
• Rebecca Anne Weiss, BA
• Elizabeth Goodwin Welch, RN
• Emma L Welch

• Physical Therapist in Oceanside, CA
• Providers in Oceanside, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.