Jacquelyn Marie Derian Boebel
Occupational Therapist - Pediatrics
2331 20th St Apt 3
Santa Monica
, California 90405-2737
Jacquelyn Marie Derian Boebel
Occupational Therapist - Pediatrics
2331 20th St Apt 3
Santa Monica
, California 90405-2737
(858) 722-3627
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About
Features
Specialties
- Occupational Therapist - Pediatrics
Languages spoken
- English
Location
First Address
- Jacquelyn Marie Derian Boebel
- 2331 20th St Apt 3
- Santa Monica, CA
- Zip : 90405-2737
- Phone : (858) 722-3627
Second Address
- Jacquelyn Marie Derian Boebel
- 2331 20th St Apt 3
- Santa Monica, CA
- Zip : 90405-2737
- Phone : (858) 722-3627
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Is Jacquelyn Marie Derian Boebel a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 225XP0200X | Occupational Therapist - Pediatrics | OT12947 | CA |
National Provider Identifier
| NPI | 1003307364 |
|---|---|
| Provider Name | Jacquelyn Marie Derian Boebel |
| First Address | Santa Monica, CA 90405-2737 |
| Second Address | Santa Monica, CA 90405-2737 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 22/05/2018 |
| Last Update Date | 13/02/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.