Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225CX0006X | Orientation and Mobility Training Provider | AVCREP CERT. 4898 | |
N | 225X00000X | Occupational Therapist | OT5361 | CA |
N | 225XL0004X | Low Vision | OT 5361 | CA |
NPI | 1427188838 |
---|---|
Provider Name | Ms. Gina Mia Di Grazia |
First Address | San Francisco, CA 94114-3438 |
Second Address | San Francisco, CA 94114-3438 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2007 |
Last Update Date | 14/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4898 | ACVREP (01) | |
5466 | ACVREP (01) | |
OT 5361 | CA BOARD OF OT (01) | CA |