Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 8111 | CA |
NPI | 1225207079 |
---|---|
Provider Name | Andrea Lee Castellano-Jaouhari |
First Address | Murrieta, CA 92562-6177 |
Second Address | Temecula, CA 92590-3625 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2008 |
Last Update Date | 07/10/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
OT0081110 | BLUE SHIELD OF CALIFORNIA (01) | CA |