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General NPI Number Information
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NPI Number | 1477124451
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Entity Type | Individual
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Provider Name | REBECCA JEAN MATHISON MSOT
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Gender | Female
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Dates
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Enumeration Date | 07/09/2021
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Last Update Date | 01/29/2023
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Provider Practice Location Address
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Address Line | 21515 HAWTHORNE BLVD STE G100
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City | TORRANCE
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State | CA
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Zip | 90503-6501
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Country | US
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Telephone | 424-571-2618
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Fax |
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Provider Business Mailing Address
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Address Line | 1025 2ND ST APT 11
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City | SANTA MONICA
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State | CA
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Zip | 90403-3643
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Country | US
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Telephone | 828-460-4787
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 14263
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 23908
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License Number State | CA
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