Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT 6303 | CA |
N | 225XG0600X | Occupational Therapist - Gerontology | OT 6303 | CA |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OT 6303 | CA |
N | 225XP0200X | Occupational Therapist - Pediatrics | OT 6303 | CA |
NPI | 1285954370 |
---|---|
Provider Name | Theresa Chilton Hayward |
First Address | Sacramento, CA 95817 |
Second Address | Sacramento, CA 95817-2307 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2010 |
Last Update Date | 11/06/2010 |