Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 10745 | CA |
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 10745 | CA |
NPI | 1811221849 |
---|---|
Provider Name | Jennifer Ann Williams |
First Address | Menlo Park, CA 94025-6223 |
Second Address | Stanford, CA 94305-2200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2009 |
Last Update Date | 23/09/2009 |