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General NPI Number Information
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NPI Number | 1174298228
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Entity Type | Individual
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Provider Name | JESSECA SMITH OTD, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 08/11/2021
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Last Update Date | 02/27/2023
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Provider Practice Location Address
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Address Line | 500 E VALLEY PKWY
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City | ESCONDIDO
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State | CA
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Zip | 92025-3054
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Country | US
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Telephone | 442-259-0207
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Fax |
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Provider Business Mailing Address
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Address Line | 1690 CAROL LEE LN
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City | ESCONDIDO
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State | CA
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Zip | 92026-1665
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Country | US
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Telephone | 858-357-1313
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 22672
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License Number State | CA
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