Healthcare Provider Details

I. General information

NPI: 1700029451
Provider Name (Legal Business Name): SAFARI SENSORY INTEGRATION AND LEARNING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2009
Last Update Date: 04/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7413 N CEDAR AVE SUITE 102
FRESNO CA
93720-3833
US

IV. Provider business mailing address

7413 N CEDAR AVE SUITE 102
FRESNO CA
93720-3833
US

V. Phone/Fax

Practice location:
  • Phone: 559-449-1557
  • Fax: 559-449-1557
Mailing address:
  • Phone: 559-449-1557
  • Fax: 559-449-1557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT2288
License Number StateCA

VIII. Authorized Official

Name: MRS. ELSABE AMELIA KRUGER
Title or Position: OWNER
Credential: OTR/L; CSI; CPAM.
Phone: 559-449-1557