Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jaclyn Danielle Buckingham, MOT, OTR/L

Individual provider Occupational Therapist · NPI 1477105062

Jaclyn Danielle Buckingham, MOT, OTR/L is an Occupational Therapist in Private Practice in Ontario, California. Qualified in 2019, 7 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
7
Licensed in
CA
In the registry since
2019
What do these letters mean?
OTR/L — Occupational Therapist, Registered and Licensed
An occupational therapist who is both nationally registered and state licensed.

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Practice location Address checks out

4688 Ontario Mills Pkwy
Ontario, CA 91764-5104
Phone: (909) 476-5747
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 20120 (CA)

Record details

NPI number1477105062
Entity typeIndividual (Type 1)
GenderFemale
Credentials MOT , OTR/L
Sole proprietorYes
NPI enumeratedJuly 12, 2019
Last updated in NPPESMay 5, 2022
Certification dateMay 5, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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