Provider Demographics
NPI:1578446597
Name:SABLAN, JESTYNE RAINA LEE (DPT)
Entity type:Individual
Prefix:
First Name:JESTYNE
Middle Name:RAINA LEE
Last Name:SABLAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8689 W CHARLESTON BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-5485
Mailing Address - Country:US
Mailing Address - Phone:702-991-6798
Mailing Address - Fax:702-628-8367
Practice Address - Street 1:8689 W CHARLESTON BLVD STE 106
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-5485
Practice Address - Country:US
Practice Address - Phone:702-991-6798
Practice Address - Fax:702-628-8367
Is Sole Proprietor?:No
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6728225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist