Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | OT 454 | CA |
N | 2251E1200X | Ergonomics | OT 454 | CA |
N | 225XE1200X | Ergonomics | OT 454 | CA |
NPI | 1285752261 |
---|---|
Provider Name | Mrs. Carolina Ong |
First Address | San Francisco, CA 94116-1411 |
Second Address | San Francisco, CA 94116-1411 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
OT 454 | CA BOARD OF OT (01) | CA |