Provider Demographics
NPI:1275060089
Name:JONES-LILLEY, SHEILA R (OT/L)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:R
Last Name:JONES-LILLEY
Suffix:
Gender:F
Credentials:OT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4795 SAN MIGUEL AVE
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92407-6878
Mailing Address - Country:US
Mailing Address - Phone:951-317-3297
Mailing Address - Fax:
Practice Address - Street 1:4795 SAN MIGUEL AVE
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92407-6878
Practice Address - Country:US
Practice Address - Phone:951-317-3297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5228225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation