Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | OT5823 | CA |
NPI | 1225321888 |
---|---|
Provider Name | Ada Suemi Oshiro |
First Address | Pasadena, CA 91109-0730 |
Second Address | Pasadena, CA 91105-3229 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2011 |
Last Update Date | 16/05/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
OT5823 | CA LICENSE (01) | CA |