Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XM0800X | Mental Health | 3738 | CA |
NPI | 1508402678 |
---|---|
Provider Name | Elizabeth Campbell Atkinson |
First Address | El Cajon, CA 92020-8209 |
Second Address | El Cajon, CA 92020-8209 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2019 |
Last Update Date | 22/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3738 | CALIFORNIA BOARD OF OCCUPATIONAL THERAPY (01) | CA |