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1083835631 NPI number — JILL MARIE KAMRUD MOT, OTR

NPI Number: 1083835631
Health Care Provider/Practitioner: JILL MARIE KAMRUD MOT, OTR

Information about “1083835631” NPI (JILL MARIE KAMRUD MOT, OTR) exists in 1083835631 in HTML format HTML  |  1083835631 in plain Text format TXT  |  1083835631 in PDF (Portable Document Format) PDF  |  1083835631 in an XML format XML  formats.

NPI Number : 1083835631 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1083835631",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "KAMRUD",
    "FirstName": "JILL",
    "MiddleName": "MARIE",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "MOT, OTR",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1659 MEADOWLARK CT",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FORTUNA",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "95540-3452",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "707-726-0304",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2700 DOLBEER ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "EUREKA",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "95501-4736",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "707-445-5111",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/01/2007",
    "LastUpdateDate": "07/08/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "225X00000X",
        "TaxonomyName": "Occupational Therapist",
        "LicenseNumber": "816",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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