Individual
MRS. JENNIFER M BASTAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
460 MARGO AVE, LONG BEACH, CA 90803-2120
(714) 326-6551
Mailing address
460 MARGO AVE, LONG BEACH, CA 90803-2120
(714) 326-6551
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5837
CA
Other
Enumeration date
08/08/2022
Last updated
08/08/2022
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