Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 12190 | CA |
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 12190 | CA |
NPI | 1710434469 |
---|---|
Provider Name | Mrs. Lauren Pillon-Beebout |
First Address | Sacramento, CA 95835-3011 |
Second Address | Sacramento, CA 95817-2217 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2016 |
Last Update Date | 09/09/2016 |