Basic Information
| Provider Information | |||||||||
| NPI: | 1114204658 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WEYLAND | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | SCOTT | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 405 | ||||||||
| Address2: | |||||||||
| City: | APTOS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 950010405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8318186832 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1441 CONSTITUTION BLVD. | ||||||||
| Address2: | NATIVIDAD MEDICAL CENTER | ||||||||
| City: | SALINAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939063100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8317554111 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/11/2011 | ||||||||
| LastUpdateDate: | 01/20/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 01/20/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2100X | 20069 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
ID Information
| ID | Type | State | Issuer | Description | 070000070 | 01 | CA | GACH FACILITY LICENSE | OTHER |