Healthcare Provider Details

I. General information

NPI: 1346332376
Provider Name (Legal Business Name): ARM AND HAND REHAB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 05/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6692 MERCHANDISE WAY STE C
DIAMOND SPRINGS CA
95619-9453
US

IV. Provider business mailing address

6692 MERCHANDISE WAY SUITE C
DIAMOND SPRINGS CA
95619-9453
US

V. Phone/Fax

Practice location:
  • Phone: 530-621-1149
  • Fax: 530-626-3049
Mailing address:
  • Phone: 530-621-1149
  • Fax: 530-626-3049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number776
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number776
License Number StateCA

VIII. Authorized Official

Name: DR. KIMBERLY ANN MORGAN
Title or Position: OWNER
Credential: OTD,OTR/L, HTC, PAM
Phone: 530-621-1149