Provider Demographics
NPI:1972750297
Name:OKON, JOSEPH KEVIN (OTR/L)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:KEVIN
Last Name:OKON
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 1:67560 EL SOMBRERO LN
Mailing Address - Street 2:
Mailing Address - City:DESERT HOT SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92241-7318
Mailing Address - Country:US
Mailing Address - Phone:323-652-8049
Mailing Address - Fax:
Practice Address - Street 1:41505 CARLOTTA DR
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92211-3279
Practice Address - Country:US
Practice Address - Phone:760-346-5420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-19
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT9836225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist