Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XF0002X | Feeding, Eating & Swallowing | OT 481 | CA |
Y | 225XM0800X | Mental Health | OT 481 | CA |
NPI | 1356680193 |
---|---|
Provider Name | Venet Cremona-Thompson |
First Address | Concord, CA 94518-3225 |
Second Address | Concord, CA 94518-3225 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2013 |
Last Update Date | 13/02/2013 |