Healthcare Provider Details

I. General information

NPI: 1134591183
Provider Name (Legal Business Name): JAMIE ROME ROSENBLUM OTR/L, CHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2015
Last Update Date: 08/23/2021
Certification Date: 08/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 BAY ST UNIT 1
SANTA MONICA CA
90405-1026
US

IV. Provider business mailing address

4387 MOTOR AVE
CULVER CITY CA
90232-3448
US

V. Phone/Fax

Practice location:
  • Phone: 310-396-8564
  • Fax:
Mailing address:
  • Phone: 310-948-1095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number019823-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number16340
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: