Healthcare Provider Details

I. General information

NPI: 1073117925
Provider Name (Legal Business Name): MISSION OCCUPATIONAL AND HAND THERAPY SERVICES APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2020
Last Update Date: 02/22/2026
Certification Date: 02/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9968 HIBERT ST STE 101
SAN DIEGO CA
92131-1036
US

IV. Provider business mailing address

12386 SYCAMORE RIDGE CT
SAN DIEGO CA
92131-3227
US

V. Phone/Fax

Practice location:
  • Phone: 858-227-7229
  • Fax: 858-221-4177
Mailing address:
  • Phone: 858-761-8101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE MILES-KESSELL
Title or Position: OWNER
Credential: OTR/L, CHT
Phone: 858-761-8101