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General NPI Number Information
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NPI Number | 1245112366
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Entity Type | Individual
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Provider Name | EILEEN JOY PONCE OTD OTR/L
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Gender | Female
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Dates
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Enumeration Date | 07/21/2025
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Last Update Date | 07/21/2025
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Provider Practice Location Address
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Address Line | 101 SAND CREEK RD
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City | BRENTWOOD
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State | CA
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Zip | 94513-2539
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Country | US
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Telephone | 925-939-8585
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Fax |
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Provider Business Mailing Address
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Address Line | 5448 CLEO CT
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City | LIVERMORE
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State | CA
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Zip | 94550-2348
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Country | US
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Telephone | 661-330-1159
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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 | 27781
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License Number State | CA
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