Provider Demographics
NPI:1679971063
Name:JAMESON, ROBERT JR (MS OTR/L, CHT)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:
Last Name:JAMESON
Suffix:JR
Gender:M
Credentials:MS OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:672 CRESCENT LN
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92084-7032
Mailing Address - Country:US
Mailing Address - Phone:240-682-3885
Mailing Address - Fax:
Practice Address - Street 1:672 CRESCENT LN
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92084-7032
Practice Address - Country:US
Practice Address - Phone:240-682-3885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-17
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07488225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist