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General NPI Number Information
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NPI Number | 1669134201
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Entity Type | Individual
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Provider Name | JOHN C AVERY OTD, OTR/L, CHT
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Gender | Male
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Dates
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Enumeration Date | 10/12/2021
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Last Update Date | 10/12/2021
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Provider Practice Location Address
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Address Line | 752 MEDICAL CENTER CT STE 303
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City | CHULA VISTA
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State | CA
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Zip | 91911-6661
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Country | US
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Telephone | 619-591-7900
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Fax |
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Provider Business Mailing Address
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Address Line | 8071 CANTON DR
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City | LEMON GROVE
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State | CA
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Zip | 91945-4416
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Country | US
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Telephone | 619-461-4939
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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 | 225XN1300X
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Taxonomy Name | Neurorehabilitation Occupational Therapist
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License Number | OT-1729
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License Number State | CA
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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 | OT-1729
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 225XE0001X
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Taxonomy Name | Environmental Modification Occupational Therapist
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License Number | OT-1729
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 225XE1200X
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Taxonomy Name | Ergonomics Occupational Therapist
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License Number | OT-1729
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 225XF0002X
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Taxonomy Name | Feeding, Eating & Swallowing Occupational Therapist
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License Number | OT-1729
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License Number State | CA
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Taxonomy #6
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Taxonomy Code | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number | OT-1729
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License Number State | CA
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Taxonomy #7
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Taxonomy Code | 225XH1200X
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Taxonomy Name | Hand Occupational Therapist
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License Number | OT-1729
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License Number State | CA
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