Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | OT 8802 | CA |
N | 2251E1200X | Ergonomics | OT 8802 | CA |
N | 225XE1200X | Ergonomics | OT 8802 | CA |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | OT 8802 | CA |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OT 8802 | CA |
Y | 225XP0200X | Occupational Therapist - Pediatrics | OT 8802 | CA |
NPI | 1669831095 |
---|---|
Provider Name | Christine Healy |
First Address | San Jose, CA 95123-5314 |
Second Address | San Jose, CA 95123-3301 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2016 |
Last Update Date | 12/02/2016 |