Provider Demographics
NPI:1033260989
Name:BROWN, JUDSON P (OT)
Entity Type:Individual
Prefix:
First Name:JUDSON
Middle Name:P
Last Name:BROWN
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:26471 CROWN VALLEY PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6378
Mailing Address - Country:US
Mailing Address - Phone:949-916-2601
Mailing Address - Fax:949-916-2302
Practice Address - Street 1:26471 CROWN VALLEY PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6378
Practice Address - Country:US
Practice Address - Phone:949-916-2601
Practice Address - Fax:949-916-2302
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAOT 1316225XH1200X
CAOT1316225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand