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NPI Code Detail

MEDICARE: MS. LEONA JOAN WILCOX OTR/L

MEDICARE: MS. LEONA JOAN WILCOX OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist11431CA

General Provider Information

NPI Number : 1477831444
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LEONA JOAN WILCOX OTR/L
Provider Business Mailing Address
First Line : 499 LINDEN AVE
Second Line :
City : AUBURN
State : CA
Zip : 95603-5226
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3030 WEBSTER ST
Second Line :
City : OAKLAND
State : CA
Zip : 94609-3411
Country : US
Telephone Number : 510-250-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2011
Last Update Date : 07/25/2011

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