Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 352626 | OR |
N | 225X00000X | Occupational Therapist | OT 60589934 | WA |
Y | 225X00000X | Occupational Therapist | OT16015 | CA |
NPI | 1003268269 |
---|---|
Provider Name | Kristi Lynne O'connor |
First Address | Palo Alto, CA 94304-1601 |
Second Address | Palo Alto, CA 94304-1601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2016 |
Last Update Date | 31/08/2021 |