Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 16879 | CA |
NPI | 1063172385 |
---|---|
Provider Name | Sara Jane Seitz |
First Address | San Luis Obispo, CA 93401-7921 |
Second Address | San Luis Obispo, CA 93401-7921 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2021 |
Last Update Date | 28/12/2021 |