Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 19004 | CA |
NPI | 1013555283 |
---|---|
Provider Name | Janine Casale |
First Address | San Diego, CA 92117-4533 |
Second Address | San Diego, CA 92121-3109 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2019 |
Last Update Date | 18/12/2019 |