Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 10610 | CA |
NPI | 1295228518 |
---|---|
Provider Name | Mrs. Rebecca Christina Lima Overby |
First Address | Stockton, CA 95210-5622 |
Second Address | Stockton, CA 95210-5622 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2018 |
Last Update Date | 11/06/2018 |