Healthcare Provider Details

I. General information

NPI: 1235456419
Provider Name (Legal Business Name): JULIE EVANS DBA ADVANCED OCCUPATIONAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2010
Last Update Date: 05/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7108 N FRESNO ST SUITE 380
FRESNO CA
93720-2938
US

IV. Provider business mailing address

7108 N FRESNO ST SUITE 380
FRESNO CA
93720-2938
US

V. Phone/Fax

Practice location:
  • Phone: 559-903-2386
  • Fax: 559-451-0564
Mailing address:
  • Phone: 559-903-2386
  • Fax: 559-451-0564

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License NumberOT8087
License Number StateCA

VIII. Authorized Official

Name: JULIE ANN EVANS
Title or Position: OCCUPATIONAL THERAPIS
Credential: OTR, CHT
Phone: 559-903-2386