Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | ||
N | 225XG0600X | Occupational Therapist - Gerontology | 9384 |
NPI | 1467110254 |
---|---|
Provider Name | Tracee Tsai |
First Address | Irvine, CA 92604-3628 |
Second Address | Newport Beach, CA 92663-3628 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2021 |
Last Update Date | 30/11/2021 |