Provider Demographics
NPI:1285683235
Name:CREAMER, DIANE (OT/CHT)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:CREAMER
Suffix:
Gender:F
Credentials:OT/CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 S ANDREASEN DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92029-1917
Mailing Address - Country:US
Mailing Address - Phone:760-591-7750
Mailing Address - Fax:760-294-9813
Practice Address - Street 1:2421 E VALLEY PKWY
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92027-2932
Practice Address - Country:US
Practice Address - Phone:760-233-9655
Practice Address - Fax:760-233-9648
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2008-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT1749225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAN040311BMedicare PIN
CAWOT1749DMedicare PIN
CAWOT1749AMedicare PIN