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NPI Code Detail

MEDICARE: DENNIS NECESITO OTD, OTR/L

MEDICARE: DENNIS NECESITO OTD, OTR/L
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
1225X00000XOccupational Therapist7360CA
2225XP0200XPediatric Occupational Therapist7360CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
17360OTHERCACALIFORNIA BOARD OF OCCUPATIONAL THERAPY

General Provider Information

NPI Number : 1588929483
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENNIS NECESITO OTD, OTR/L
Provider Business Mailing Address
First Line : 630 S INDIAN HILL BLVD STE 5
Second Line :
City : CLAREMONT
State : CA
Zip : 91711-5461
Country : US
Telephone Number : 213-618-9149
Fax Number :
Provider Business Practice Location Address
First Line : 630 S INDIAN HILL BLVD STE 5
Second Line :
City : CLAREMONT
State : CA
Zip : 91711-5461
Country : US
Telephone Number : 909-451-8521
Fax Number : 909-593-1211
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2012
Last Update Date : 04/29/2020

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