Healthcare Provider Details

I. General information

NPI: 1497072052
Provider Name (Legal Business Name): JESSICA MARGARET MARFIA MS,OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JESSICA MARGARET VALLANCE MS, OTR/L

II. Dates (important events)

Enumeration Date: 04/22/2010
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17800 US HIGHWAY 18
APPLE VALLEY CA
92307-1221
US

IV. Provider business mailing address

6839 SVL BOX
VICTORVILLE CA
92395-5185
US

V. Phone/Fax

Practice location:
  • Phone: 760-955-7600
  • Fax:
Mailing address:
  • Phone: 269-352-4293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5201007693
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number12747
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: