Individual
MR. TIMOTHY P HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTRL
Contact information
Practice address
1216 W BENSON AVE, RIDGECREST, CA 93555-4708
(760) 375-9890
Mailing address
1216 W BENSON AVE, RIDGECREST, CA 93555-4708
(760) 375-9890
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
—
225XH1200X
Hand Occupational Therapist
—
—
225XN1300X
Neurorehabilitation Occupational Therapist
Primary
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00002628
LICENSE
WA
01
—
1003611
NATIONAL NBCOT
—
01
—
3988
OT LICENSE
CA
Enumeration date
12/13/2006
Last updated
09/11/2025
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