Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | OT15805 | CA |
Y | 225XP0200X | Occupational Therapist - Pediatrics | OT15805 | CA |
NPI | 1013382993 |
---|---|
Provider Name | Federica Mucci |
First Address | Sacramento, CA 95825-2395 |
Second Address | Sacramento, CA 95825-2395 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2015 |
Last Update Date | 03/12/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
OT15805 | LICENSE (01) | CA |