Provider Demographics
NPI:1528478062
Name:WELCOME, DEBORAH JUSTINE (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:JUSTINE
Last Name:WELCOME
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:DEBORAH
Other - Middle Name:JUSTINE
Other - Last Name:WELCOME
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:6180 BROCKTON AVE
Mailing Address - Street 2:102
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-2228
Mailing Address - Country:US
Mailing Address - Phone:951-684-6500
Mailing Address - Fax:951-684-0051
Practice Address - Street 1:6180 BROCKTON AVE
Practice Address - Street 2:102
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-2228
Practice Address - Country:US
Practice Address - Phone:951-684-6500
Practice Address - Fax:951-684-0051
Is Sole Proprietor?:No
Enumeration Date:2014-05-06
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5811225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics