Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OTA147 | CA |
NPI | 1003482910 |
---|---|
Provider Name | Julie Barto |
First Address | San Jose, CA 95117-2029 |
Second Address | Los Gatos, CA 95032-7645 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2021 |
Last Update Date | 01/06/2021 |