Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 7860 | CA |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | OT7860 | CA |
NPI | 1295247872 |
---|---|
Provider Name | Dean Aclan |
First Address | San Marcos, CA 92069-4207 |
Second Address | Escondido, CA 92025-2557 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2017 |
Last Update Date | 03/11/2017 |