Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 74 | CA |
NPI | 1245771971 |
---|---|
Provider Name | Mrs. Amita Kumar Pani |
First Address | San Ramon, CA 94582-5284 |
Second Address | Walnut Creek, CA 94595-2201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2017 |
Last Update Date | 13/01/2022 |