Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 1640 | CA |
NPI | 1003221128 |
---|---|
Provider Name | Katy Schlossberg |
First Address | San Diego, CA 92128-5652 |
Second Address | San Diego, CA 92128-5652 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2014 |
Last Update Date | 26/06/2014 |