Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 13065 | CA |
NPI | 1356820351 |
---|---|
Provider Name | Shalini Rao Paka |
First Address | Dublin, CA 94568-7400 |
Second Address | Castro Valley, CA 94546-6900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2018 |
Last Update Date | 09/08/2018 |