Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 21866 | CA |
NPI | 1013599778 |
---|---|
Provider Name | Erika Michelle Cruz |
First Address | Oakley, CA 94561-2786 |
Second Address | Tracy, CA 95376-4621 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2021 |
Last Update Date | 22/04/2021 |