Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 2481 | CA |
NPI | 1962543157 |
---|---|
Provider Name | Sonia Pascual Ricaporte |
First Address | Benicia, CA 94510-3434 |
Second Address | Vallejo, CA 94589-2441 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2007 |
Last Update Date | 11/01/2022 |