Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XG0600X | Occupational Therapist - Gerontology | 12295 | CA |
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 12295 | CA |
NPI | 1861869877 |
---|---|
Provider Name | Mrs. Sylvia Gulen Jones |
First Address | Oakland, CA 94611-4615 |
Second Address | Oakland, CA 94611-4615 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2015 |
Last Update Date | 23/11/2021 |