Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 2688 | CA |
NPI | 1043332968 |
---|---|
Provider Name | Mrs. Kathryn Mary Foster |
First Address | Yucaipa, CA 92399-6015 |
Second Address | Fontana, CA 92335-6720 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2007 |
Last Update Date | 01/12/2021 |