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NPI Code Detail

MEDICARE: ESTHER GREEN

MEDICARE: ESTHER GREEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225XP0200XPediatric Occupational Therapist

General Provider Information

NPI Number : 1336091115
Entity Type Code : Individual
Provider Name (Legal Business Name) : ESTHER GREEN
Provider Business Mailing Address
First Line : 2912 W CANYON AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92123-4650
Country : US
Telephone Number : 805-448-2708
Fax Number :
Provider Business Practice Location Address
First Line : 10431 COMMERCE ST
Second Line :
City : REDLANDS
State : CA
Zip : 92374-0110
Country : US
Telephone Number : 909-735-7654
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2026
Last Update Date : 02/12/2026

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Directions to “ ESTHER GREEN ” Practice Location

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