| NPI | 1609121052 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACIELA PAGANO Program Director 510-333-4579 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CA 11902) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: CA 11902) |
| Enumeration Date | 2012-07-20 |
| Last Update Date | 2019-08-15 |