Provider Demographics
NPI:1902880115
Name:ROWE, DARRELL GARTH (OTR/L, CHT)
Entity type:Individual
Prefix:
First Name:DARRELL
Middle Name:GARTH
Last Name:ROWE
Suffix:
Gender:M
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26315 AVERY PL
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-4956
Mailing Address - Country:US
Mailing Address - Phone:951-445-0578
Mailing Address - Fax:
Practice Address - Street 1:29645 RANCHO CALIFORNIA RD STE 234
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-5211
Practice Address - Country:US
Practice Address - Phone:951-506-3001
Practice Address - Fax:951-506-3002
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 3949225XH1200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB269076Medicare PIN
CACA233110Medicare PIN
CAOT0039490OtherBLUE SHIELD OF CALIFORNIA