Provider Demographics
NPI:1821020793
Name:SUMMERS, DEBRA JEAN (OTR /L, CHT)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:JEAN
Last Name:SUMMERS
Suffix:
Gender:F
Credentials:OTR /L, CHT
Other - Prefix:
Other - First Name:DEBBIE
Other - Middle Name:
Other - Last Name:SUMMERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR / L, CHT
Mailing Address - Street 1:15525 POMERADO RD.
Mailing Address - Street 2:SUITE C-8
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-2426
Mailing Address - Country:US
Mailing Address - Phone:858-674-4263
Mailing Address - Fax:858-674-4380
Practice Address - Street 1:15525 POMERADO RD.
Practice Address - Street 2:SUITE C-8
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-2426
Practice Address - Country:US
Practice Address - Phone:858-674-4263
Practice Address - Fax:858-674-4380
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT601225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4490070001Medicare NSC
CAN289819AMedicare PIN