NPIMap

Organization Active NPI

Educational Therapy Assessment & Services

  • Developmental Disabilities Clinic/Center
  • Yucaipa, CA
National Provider Identifier
1790029312
Registry record updated Nov 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
Legal business name
EDUCATIONAL THERAPY ASSESSMENT & SERVICES
Practice address
34590 County Line Rd
Suite 7
Yucaipa, CA 92399-5303
Phone
(909) 795-4255
Fax
(909) 795-4438
NPI assigned
Nov 20, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2012

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

Authorized official

Name
Ms. Doreen Ann Spearman, PT
Title
President/Executive Director
Phone
(909) 795-4255

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251P0200X
Feeding, Eating & Swallowing Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XF0002X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X
Developmental Disabilities Clinic/Center 261QD1600X Primary
Physical Therapy Clinic/Center 261QP2000X PT10699 CA

Addresses

Primary practice location

34590 County Line Rd
Suite 7
Yucaipa, CA 92399-5303

Mailing address

34590 County Line Rd
Suite 7
Yucaipa, CA 92399-5303
Phone (909) 795-4255

Other names 1

  • ETAS Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Educational Therapy Assessment Services3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

34590 County Line Rd
Ste 7
Yucaipa, CA 92399
Phone (909) 795-4255

NPI Registry JSON

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

{
    "created_epoch": "1353369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353369600000",
    "number": "1790029312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34590 COUNTY LINE RD",
            "address_2": "SUITE 7",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923995303",
            "telephone_number": "909-795-4255",
            "fax_number": "909-795-4438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34590 COUNTY LINE RD",
            "address_2": "SUITE 7",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923995303",
            "telephone_number": "909-795-4255",
            "fax_number": "909-795-4438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDUCATIONAL THERAPY ASSESSMENT & SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-20",
        "last_updated": "2012-11-20",
        "status": "A",
        "authorized_official_last_name": "SPEARMAN",
        "authorized_official_first_name": "DOREEN",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT/EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "909-795-4255",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XF0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Feeding, Eating & Swallowing",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "PT10699",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ETAS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yucaipa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2012; 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.