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NPI Code Detail

MEDICARE: ALISON WEINGARTEN COURSON OTR/L

MEDICARE: ALISON WEINGARTEN COURSON 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
1225XP0200XPediatric Occupational TherapistOTR/L 2449CA
2225X00000XOccupational TherapistOTR/L 2449CA
3225XF0002XFeeding, Eating & Swallowing Occupational TherapistOTR/L 2449CA

General Provider Information

NPI Number : 1902838279
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALISON WEINGARTEN COURSON OTR/L
Provider Business Mailing Address
First Line : 823 GATEWAY CENTER WAY
Second Line :
City : SAN DIEGO
State : CA
Zip : 92102-4541
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1809 NATIONAL AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92113-2113
Country : US
Telephone Number : 619-515-2321
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2006
Last Update Date : 03/02/2009

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