Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 5228 | CA |
NPI | 1275060089 |
---|---|
Provider Name | Sheila R Jones-Lilley |
First Address | San Bernardino, CA 92407-6878 |
Second Address | San Bernardino, CA 92407-6878 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2017 |
Last Update Date | 11/05/2017 |