Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 396 | CA |
NPI | 1003225046 |
---|---|
Provider Name | Silvia Weimer |
First Address | Stockton, CA 95219-5443 |
Second Address | Stockton, CA 95209-1807 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2014 |
Last Update Date | 04/08/2014 |