Runell Lucile Packer, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT94 Issued in CA

Practice address

10825 Arrow Rte
2ND Floor
Rancho Cucamonga, CA 91730-4800

Phone

(909) 458-9487

Fax

(909) 945-0819

NPI assigned

Jan 24, 2008

Last updated

Jan 24, 2008By the provider in NPPES

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1201132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201132800000",
    "number": "1356528004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10825 ARROW RTE",
            "address_2": "2ND FLOOR",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917304800",
            "telephone_number": "909-458-9487",
            "fax_number": "909-945-0819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10825 ARROW RTE",
            "address_2": "2ND FLOOR",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917304800",
            "telephone_number": "909-458-9487",
            "fax_number": "909-945-0819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACKER",
        "first_name": "RUNELL",
        "middle_name": "LUCILE",
        "name_prefix": "Miss",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-24",
        "last_updated": "2008-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT94",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2008; 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.