Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 3640 | CA |
NPI | 1174815559 |
---|---|
Provider Name | Mrs. Christy Lee Ortzow |
First Address | Castro Valley, CA 94552-1708 |
Second Address | Castro Valley, CA 94552-1708 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2011 |
Last Update Date | 04/05/2011 |