Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 1614 | CA |
Y | 225XG0600X | Occupational Therapist - Gerontology | 1614 | CA |
NPI | 1831589290 |
---|---|
Provider Name | Josefina Linis Castro |
First Address | Hayward, CA 94544 |
Second Address | Hayward, CA 94544-2725 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2015 |
Last Update Date | 23/01/2015 |