Provider Demographics
NPI:1952339947
Name:UHLES-JOHNSON, RONDA BROOKE (OTRL)
Entity Type:Individual
Prefix:
First Name:RONDA
Middle Name:BROOKE
Last Name:UHLES-JOHNSON
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 SOLAR DR
Mailing Address - Street 2:SUITE 215
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-2645
Mailing Address - Country:US
Mailing Address - Phone:805-604-1924
Mailing Address - Fax:805-604-0176
Practice Address - Street 1:2001 SOLAR DR
Practice Address - Street 2:SUITE 215
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-2645
Practice Address - Country:US
Practice Address - Phone:805-604-1924
Practice Address - Fax:805-604-0176
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 1814225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOT0018140OtherBLUE SHIELD
CAOT0018140OtherBLUE SHIELD