Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225000000X | Orthotic Fitter | ||
N | 2251E1200X | Ergonomics | ||
N | 225XE1200X | Ergonomics | ||
Y | 225XH1200X | Occupational Therapist - Hand | ||
N | 225XN1300X | Occupational Therapist - Neurorehabilitation |
NPI | 1730393497 |
---|---|
Provider Name | Mojca C Herman |
First Address | Redondo Beach, CA 90277-5104 |
Second Address | Redondo Beach, CA 90277-5104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2007 |
Last Update Date | 08/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2164919 | FIRST HEALTH PIN (01) | |
300819400 | DEPT OF LABOR PIN (01) | |
7507553 | AETNA PIN (01) | |
OT0000170 | BLUE SHIELD (01) | |
P00229468 | MEDICARE PIN-PALMETTO GBA (01) |