Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 12814 | CA |
NPI | 1013470640 |
---|---|
Provider Name | Mrs. Sonoe M Oft |
First Address | Santa Rosa, CA 95401-5751 |
Second Address | Santa Rosa, CA 95405-4801 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2019 |
Last Update Date | 10/04/2019 |