Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 15159 | CA |
NPI | 1255499901 |
---|---|
Provider Name | Alexis Tucker |
First Address | Pleasanton, CA 94588-8547 |
Second Address | Pleasanton, CA 94588-8547 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2006 |
Last Update Date | 26/01/2022 |