Individual
JAY ALAN FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
1425 E PROSPERITY AVE, TULARE, CA 93274-8051
(559) 631-4588
(559) 271-6970
Mailing address
701 W CENTER AVE, VISALIA, CA 93291-6015
(559) 713-6806
(559) 713-6809
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4938
CA
225X00000X
Occupational Therapist
OT18659
FL
225XH1200X
Hand Occupational Therapist
4938
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4938
OT STATE LIC
CA
01
—
OT18659
OT STATE LICENCSE
FL
Enumeration date
04/16/2007
Last updated
05/05/2020
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