Healthcare Provider Details

I. General information

NPI: 1194353011
Provider Name (Legal Business Name): ABIGAIL EGUINOA OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2020
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9351 FEICKERT DR
ELK GROVE CA
95624-2800
US

IV. Provider business mailing address

7507 CORAL LN
STOCKTON CA
95207-1532
US

V. Phone/Fax

Practice location:
  • Phone: 916-686-7716
  • Fax:
Mailing address:
  • Phone: 209-981-1276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number27041
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: