Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | CA |
NPI | 1093935033 |
---|---|
Provider Name | Ms. L Inda Marina C Cabanilla Maza |
First Address | San Francisco, CA 94109-5417 |
Second Address | San Francisco, CA 94109-5417 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2007 |
Last Update Date | 08/07/2007 |