Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251H1300X | Human Factors | OT2301 | CA |
N | 225XH1300X | Human Factors | OT2301 | CA |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | OT2301 | CA |
N | 225XR0403X | Driving and Community Mobility | OT2301 | CA |
NPI | 1770555302 |
---|---|
Provider Name | Ms. Debra Rae Ricker |
First Address | Los Alamitos, CA 90720-3969 |
Second Address | Laguna Hills, CA 92653-3144 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2006 |
Last Update Date | 08/07/2007 |