Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT776 | CA |
N | 2251E1200X | Ergonomics | OT776 | CA |
N | 225XE1200X | Ergonomics | OT776 | CA |
N | 225XH1200X | Occupational Therapist - Hand | OT776 | CA |
NPI | 1891700191 |
---|---|
Provider Name | Kimberly Ann Morgan |
First Address | Diamond Springs, CA 95619-9453 |
Second Address | Diamond Springs, CA 95619-9453 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2006 |
Last Update Date | 18/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
ZZZ05534Z | BS (01) | CA |