Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 4268 | CA |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 4268 | CA |
Y | 225XP0200X | Occupational Therapist - Pediatrics | 4268 | CA |
NPI | 1295057404 |
---|---|
Provider Name | Roxanne Janine Moniz |
First Address | Castro Valley, CA 94546-3104 |
Second Address | Castro Valley, CA 94546-3104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2010 |
Last Update Date | 22/12/2010 |