Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 13500 | CA |
NPI | 1295089837 |
---|---|
Provider Name | Cassandra Whittington |
First Address | Kihei, HI 96753-9565 |
Second Address | San Rafael, CA 94901-4840 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/11/2012 |
Last Update Date | 01/10/2019 |