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General NPI Number Information
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NPI Number | 1083091714
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Entity Type | Organization
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Legal Business Name | REHABCARE
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Dates
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Enumeration Date | 05/01/2015
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Last Update Date | 05/01/2015
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Provider Practice Location Address
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Address Line | 13075 EVENING CREEK DR S
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City | SAN DIEGO
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State | CA
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Zip | 92128-8101
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Country | US
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Telephone | 858-486-0410
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Fax | 858-486-0440
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Provider Business Mailing Address
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Address Line | 13075 EVENING CREEK DR S
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City | SAN DIEGO
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State | CA
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Zip | 92128-8101
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Country | US
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Telephone | 858-486-0410
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Fax | 858-486-0440
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | MISS SHIOW-SHIN JESSICA CHEN
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Credential | OTR/L
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Telephone | 858-386-2388
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number | OT2615
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License Number State | CA
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