Healthcare Provider Details

I. General information

NPI: 1679884563
Provider Name (Legal Business Name): JOAN LOUISE DAEMS JOAN DAEMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JOAN DAEMS OTR

II. Dates (important events)

Enumeration Date: 06/25/2010
Last Update Date: 12/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25554 MORNING MIST DR
STEVENSON RANCH CA
91381-1836
US

IV. Provider business mailing address

25554 MORNING MIST DR
STEVENSON RANCH CA
91381-1836
US

V. Phone/Fax

Practice location:
  • Phone: 661-670-8502
  • Fax:
Mailing address:
  • Phone: 661-670-8502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number12329
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: