Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | AA377606 | CA |
NPI | 1013245554 |
---|---|
Provider Name | Mrs. Joan Marie Trumbull |
First Address | Santa Ana, CA 92705 |
Second Address | Santa Ana, CA 92705 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2009 |
Last Update Date | 20/11/2009 |