Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 217 | CA |
NPI | 1174681340 |
---|---|
Provider Name | Paul B. Whitney |
First Address | Vacaville, CA 95688-9240 |
Second Address | Vallejo, CA 94589-2441 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2006 |
Last Update Date | 11/02/2022 |