Individual
MRS. JESSICA NICOLE DE BRUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
1965 COULSTON ST, UNIT #63, LOMA LINDA, CA 92354-1740
(909) 800-2049
Mailing address
1965 COULSTON ST, UNIT #63, LOMA LINDA, CA 92354-1740
(909) 800-2049
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
11519
CA
Other
Enumeration date
04/08/2011
Last updated
04/08/2011
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