Individual
JACQUELYN MARIE DERIAN BOEBEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2331 20TH ST APT 3, SANTA MONICA, CA 90405-2737
(858) 722-3627
Mailing address
2331 20TH ST APT 3, SANTA MONICA, CA 90405-2737
(858) 722-3627
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT12947
CA
Other
Enumeration date
05/22/2018
Last updated
02/13/2021
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