MEDICARE: MR. JONATHAN OSKINS

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
1	175T00000X	Peer Specialist
2	225400000X	Rehabilitation Practitioner

General Provider Information

NPI Number	:	1346600285
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JONATHAN OSKINS

Provider Business Mailing Address
First Line	:	8330 LAUREL CANYON BLVD
Second Line	:	207
City	:	SUN VALLEY
State	:	CA
Zip	:	91352-3862
Country	:	US
Telephone Number	:	818-504-2119
Fax Number	:

Provider Business Practice Location Address
First Line	:	8330 LAUREL CANYON BLVD
Second Line	:	207
City	:	SUN VALLEY
State	:	CA
Zip	:	91352-3862
Country	:	US
Telephone Number	:	818-504-2119
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2016
Last Update Date	:	03/18/2016

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Directions to “ MR. JONATHAN OSKINS ” Practice Location

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