Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | OT 9859 | CA |
Y | 225XH1200X | Occupational Therapist - Hand | OT 9859 | CA |
NPI | 1245283894 |
---|---|
Provider Name | Mrs. Audrey Chen-Ma |
First Address | Arcadia, CA 91007-7502 |
Second Address | Arcadia, CA 91007-7502 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 29/01/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1245283894 | NPI (01) | CA |