Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | OT1749 | CA |
NPI | 1285683235 |
---|---|
Provider Name | Diane Creamer |
First Address | Escondido, CA 92029-1917 |
Second Address | Escondido, CA 92027-2932 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2006 |
Last Update Date | 20/10/2008 |