Provider Demographics
NPI:1194264093
Name:SAN DIEGO OCCUPATIONAL THERAPY
Entity type:Organization
Organization Name:SAN DIEGO OCCUPATIONAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:VOYLES
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:949-573-7659
Mailing Address - Street 1:999 N PACIFIC ST UNIT B212
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-2025
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6264 FERRIS SQ
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-3204
Practice Address - Country:US
Practice Address - Phone:619-940-4128
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-13
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17116251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services