Healthcare Provider Details

I. General information

NPI: 1326468653
Provider Name (Legal Business Name): MEGAN SETO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2014
Last Update Date: 11/10/2024
Certification Date: 11/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

H BERRY DR
MOUNTAIN VIEW CA
94043-1583
US

IV. Provider business mailing address

H BERRY DR
MOUNTAIN VIEW CA
94043-1583
US

V. Phone/Fax

Practice location:
  • Phone: 650-204-0677
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number19570
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: