Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225000000X | Orthotic Fitter | ||
N | 225X00000X | Occupational Therapist | 4803 | CA |
N | 2251E1200X | Ergonomics | ||
N | 225XE1200X | Ergonomics | ||
N | 225XH1200X | Occupational Therapist - Hand | 9611000317 | CA |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation |
NPI | 1205926912 |
---|---|
Provider Name | Stacy V Cook |
First Address | Calabasas, CA 91302-1319 |
Second Address | Calabasas, CA 91302-1319 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4803 | CBOT (01) | CA |
915259 | NBCOT (01) | |
9611000317 | CHT LICENSE (01) | CA |