Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251E1200X | Ergonomics | OT5723 | CA |
N | 225XE1200X | Ergonomics | OT5723 | CA |
Y | 225XH1200X | Occupational Therapist - Hand | OT5723 | CA |
NPI | 1073521688 |
---|---|
Provider Name | Derek Thomas Alday Robinson |
First Address | Stockton, CA 95204-5536 |
Second Address | Stockton, CA 95204-5536 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2006 |
Last Update Date | 09/05/2017 |