MEDICARE: JANICE D ROCKER OTD OTR L CHT

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	225X00000X	Occupational Therapist	OT2205	CA

General Provider Information

NPI Number	:	1851336556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANICE D ROCKER OTD OTR L CHT

Provider Business Mailing Address
First Line	:	1520 SAN PABLO ST
Second Line	:	SUITE 2200
City	:	LOS ANGELES
State	:	CA
Zip	:	90033-5310
Country	:	US
Telephone Number	:	323-442-6050
Fax Number	:	323-442-6051

Provider Business Practice Location Address
First Line	:	1520 SAN PABLO ST
Second Line	:	SUITE 2200
City	:	LOS ANGELES
State	:	CA
Zip	:	90033-5310
Country	:	US
Telephone Number	:	323-442-6050
Fax Number	:	323-442-6051

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

Provider Enumeration Date	:	06/17/2006
Last Update Date	:	10/29/2014

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