Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 6589 | CA |
NPI | 1053607374 |
---|---|
Provider Name | Mrs. Angela Allison Tinson |
First Address | Redwood City, CA 94063-2619 |
Second Address | San Jose, CA 95128-4817 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2011 |
Last Update Date | 06/04/2017 |