Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | OT 6494 | CA |
NPI | 1205861275 |
---|---|
Provider Name | Kristin M Savage |
First Address | Oxnard, CA 93036-2645 |
Second Address | Oxnard, CA 93036-2645 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
OT0064940 | BLUE SHIELD (01) | CA |