Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | OT-1729 | CA |
N | 225XE0001X | Environmental Modification | OT-1729 | CA |
N | 2251E1200X | Ergonomics | OT-1729 | CA |
N | 225XE1200X | Ergonomics | OT-1729 | CA |
N | 225XF0002X | Feeding, Eating & Swallowing | OT-1729 | CA |
Y | 225XH1200X | Occupational Therapist - Hand | OT-1729 | CA |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | OT-1729 | CA |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OT-1729 | CA |
NPI | 1669134201 |
---|---|
Provider Name | Dr. John C Avery |
First Address | Lemon Grove, CA 91945-4416 |
Second Address | Chula Vista, CA 91911-6661 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2021 |
Last Update Date | 12/10/2021 |