Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 13948 | CA |
N | 225XE0001X | Environmental Modification | 13948 | CA |
N | 225XG0600X | Occupational Therapist - Gerontology | 13948 | CA |
N | 2251H1300X | Human Factors | 13948 | CA |
N | 225XH1300X | Human Factors | 13948 | CA |
N | 225XL0004X | Low Vision | 13948 | CA |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 13948 | CA |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 13948 | CA |
N | 225XR0403X | Driving and Community Mobility | 13948 | CA |
NPI | 1255862769 |
---|---|
Provider Name | Jennie C Milliner |
First Address | Beaumont, CA 92223-8130 |
Second Address | Beaumont, CA 92223-8130 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2017 |
Last Update Date | 16/10/2018 |