=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770355158
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | APRIL PERRYMAN OTR/L
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/27/2023
-----------------------------------------------------
Last Update Date | 10/27/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 301 E VANDERBILT WAY STE 100
-----------------------------------------------------
City | SAN BERNARDINO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92408-3556
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 909-567-2661
-----------------------------------------------------
Fax | 909-567-2685
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4959 PALO VERDE ST STE 109C
-----------------------------------------------------
City | MONTCLAIR
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91763-2358
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 909-971-3092
-----------------------------------------------------
Fax | 909-971-3092
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------