Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 5176 | CA |
N | 225XH1200X | Occupational Therapist - Hand | 1031100122 |
NPI | 1225187453 |
---|---|
Provider Name | Becca D. Johnson |
First Address | Sacramento, CA 95827-2539 |
Second Address | Auburn, CA 95603-2458 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2007 |
Last Update Date | 24/07/2015 |