Jacob Baquir, MHA, OTR/L

Individual provider Active NPI Occupational Therapist · Carson, CA

NPI 1003299736 · NPPES record last updated Jun 30, 2015

Key facts

NPI
1003299736
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
OT 8854 (CA)
Practice address
424 W 231St St
Carson, CA 90745-4637
Phone
(310) 408-5611
NPI assigned
Jun 30, 2015
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
OT 8854CAMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT 8854 CA Yes

Addresses

Primary practice location

424 W 231St St
Carson, CA 90745-4637

Mailing address

424 W 231St St
Carson, CA 90745-4637

Other providers in Carson, CA

All providers in Carson, CA · Occupational Therapist in California

Sources for this page

Verify at the official NPI Registry.