Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | OT8302 | CA |
NPI | 1457523904 |
---|---|
Provider Name | Mr. Kevin Stamps |
First Address | Piedmont, CA 94611-3334 |
Second Address | San Francisco, CA 94121-1545 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2008 |
Last Update Date | 25/03/2008 |