Provider Demographics
NPI:1023887668
Name:MAYS-SPEIR, JERRA BERNIECE (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:JERRA
Middle Name:BERNIECE
Last Name:MAYS-SPEIR
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1464 TURNSTONE CT
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92545-2147
Mailing Address - Country:US
Mailing Address - Phone:951-473-4610
Mailing Address - Fax:
Practice Address - Street 1:4211 VALLEY VIEW AVE
Practice Address - Street 2:
Practice Address - City:NORCO
Practice Address - State:CA
Practice Address - Zip Code:92860-3502
Practice Address - Country:US
Practice Address - Phone:951-473-4610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-22
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT25064225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist