Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 12412 | FL |
Y | 225XP0200X | Occupational Therapist - Pediatrics | 10834 | CA |
NPI | 1073690574 |
---|---|
Provider Name | Ms. Tannia G Cisneros |
First Address | Sunnyvale, CA 94089-2220 |
Second Address | Sunnyvale, CA 94089 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 24/07/2018 |