Provider Demographics
NPI:1306171574
Name:DAVIS, JAMES ROBERT (OTR/L)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:ROBERT
Last Name:DAVIS
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3033 RANCHO LA PRESA
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-2222
Mailing Address - Country:US
Mailing Address - Phone:760-931-0405
Mailing Address - Fax:760-931-9987
Practice Address - Street 1:3033 RANCHO LA PRESA
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-2222
Practice Address - Country:US
Practice Address - Phone:760-931-0405
Practice Address - Fax:760-931-9987
Is Sole Proprietor?:No
Enumeration Date:2009-10-06
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 5183225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics