Provider Demographics
NPI:1609815141
Name:ROBINSON, JEAN R (OT)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:R
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:200 NEWPORT CENTER DR
Mailing Address - Street 2:#213
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7501
Mailing Address - Country:US
Mailing Address - Phone:949-644-1322
Mailing Address - Fax:949-644-0316
Practice Address - Street 1:8929 WILSHIRE BLVD
Practice Address - Street 2:STE 304
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-1938
Practice Address - Country:US
Practice Address - Phone:310-854-0529
Practice Address - Fax:310-854-0768
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAOT 2401225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWOT2401BOtherMEDICARE PTAN