Provider Demographics
NPI:1760402929
Name:BURON, MARILYN SHIPPEY (OTR/L, CHT)
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:SHIPPEY
Last Name:BURON
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10713 BALLYSTOCK CT
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-3603
Mailing Address - Country:US
Mailing Address - Phone:858-549-9963
Mailing Address - Fax:
Practice Address - Street 1:9040 FRIARS RD
Practice Address - Street 2:SUITE 410
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-5859
Practice Address - Country:US
Practice Address - Phone:619-283-9610
Practice Address - Fax:619-283-9692
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT3171225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand