Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 19037 | CA |
NPI | 1003451022 |
---|---|
Provider Name | Tessa Tsai |
First Address | Roseville, CA 95661-2931 |
Second Address | Roseville, CA 95661-2931 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2019 |
Last Update Date | 13/11/2019 |