Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | OT 13767 | CA |
NPI | 1679961296 |
---|---|
Provider Name | Ms. Maureen O'shay |
First Address | Elk Grove, CA 95758-5464 |
Second Address | Sacramento, CA 95838-2609 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2015 |
Last Update Date | 05/01/2015 |