Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | ||
N | 225XE0001X | Environmental Modification | ||
N | 225XG0600X | Occupational Therapist - Gerontology | ||
Y | 225XL0004X | Low Vision | 11382 | CA |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | ||
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation |
NPI | 1407470966 |
---|---|
Provider Name | Andrea Muncada |
First Address | San Diego, CA 92115-3826 |
Second Address | San Diego, CA 92115-3826 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2020 |
Last Update Date | 22/09/2020 |