Provider Demographics
NPI:1437997434
Name:ESPINOSA, JASON LEE (OTR/L)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:LEE
Last Name:ESPINOSA
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1903 ROYAL OAKS DR
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-6306
Mailing Address - Country:US
Mailing Address - Phone:201-618-3493
Mailing Address - Fax:
Practice Address - Street 1:101 UHLAND RD STE 112
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-6681
Practice Address - Country:US
Practice Address - Phone:512-396-0872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX124632225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics