Individual
DR. JESSICA MARIE BANIQUED MATEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
15265 ALTON PKWY STE 140, IRVINE, CA 92618-2605
(949) 835-3746
Mailing address
2150 S STATE COLLEGE BLVD APT 4019, ANAHEIM, CA 92806-0141
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
515297
—
Other
Enumeration date
07/22/2025
Last updated
07/22/2025
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