Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT2546 | CA |
N | 225XE0001X | Environmental Modification | ||
N | 225XG0600X | Occupational Therapist - Gerontology | ||
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | ||
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation |
NPI | 1942679840 |
---|---|
Provider Name | Nina Margaret Rea |
First Address | Oakland, CA 94611-1411 |
Second Address | Oakland, CA 94611-1411 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2015 |
Last Update Date | 21/09/2015 |