Provider Demographics
NPI:1417403320
Name:DE JONG, SASKIA
Entity Type:Individual
Prefix:
First Name:SASKIA
Middle Name:
Last Name:DE JONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:934 NOTTINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-6663
Mailing Address - Country:US
Mailing Address - Phone:909-379-8155
Mailing Address - Fax:
Practice Address - Street 1:101 E REDLANDS BLVD STE 230
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-4724
Practice Address - Country:US
Practice Address - Phone:909-735-7654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-30
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT8671225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics