Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251E1200X | Ergonomics | OT 4346 | CA |
Y | 225XE1200X | Ergonomics | OT 4346 | CA |
NPI | 1295814242 |
---|---|
Provider Name | Jeannie Ellen Craig |
First Address | San Jose, CA 95161-2260 |
Second Address | Walnut Creek, CA 94598-3349 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2006 |
Last Update Date | 08/07/2007 |