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General NPI Number Information
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NPI Number | 1275653677
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Entity Type | Individual
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Provider Name | JAMIE LEE CRUZ MOTRL
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Gender | Female
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 28786 GREENWOOD PL
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City | CASTAIC
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State | CA
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Zip | 91384-4321
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Country | US
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Telephone | 661-600-8809
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Fax |
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Provider Business Mailing Address
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Address Line | 28786 GREENWOOD PL
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City | CASTAIC
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State | CA
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Zip | 91384-4321
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Country | US
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Telephone | 661-600-8809
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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 | OT. 006856
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 9461
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License Number State | CA
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