Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | OT650 | CA |
N | 225XH1200X | Occupational Therapist - Hand | OT650 | CA |
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | OT650 | CA |
NPI | 1578636445 |
---|---|
Provider Name | Patricia Ann Koerner |
First Address | Tustin, CA 92780-2551 |
Second Address | Tustin, CA 92780-2551 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2006 |
Last Update Date | 16/09/2018 |