Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | OT887 | CA |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | OT887 | CA |
NPI | 1801211313 |
---|---|
Provider Name | Meri Escobar |
First Address | Irvine, CA 92602-0110 |
Second Address | Irvine, CA 92602-0110 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2014 |
Last Update Date | 20/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
OT887 | OCCUPATIONAL THERAPY LICENSE (01) | CA |