Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 2003310 | CA |
NPI | 1154886513 |
---|---|
Provider Name | Christine Clermont |
First Address | Oceanside, CA 92056-4618 |
Second Address | Vista, CA 92084-7200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2019 |
Last Update Date | 09/02/2019 |