Provider Demographics
NPI:1881890515
Name:DUBEN, ORA (OTRL)
Entity type:Individual
Prefix:
First Name:ORA
Middle Name:
Last Name:DUBEN
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:ORA
Other - Middle Name:
Other - Last Name:GREER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTRL
Mailing Address - Street 1:11150 MADRIGAL ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-1233
Mailing Address - Country:US
Mailing Address - Phone:858-672-2285
Mailing Address - Fax:
Practice Address - Street 1:4510 VIEWRIDGE AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1637
Practice Address - Country:US
Practice Address - Phone:858-502-1350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-21
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA938225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics