Healthcare Provider Details
I. General information
NPI: 1053974246
Provider Name (Legal Business Name): BABY MOVES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/15/2019
Last Update Date: 04/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
434 CALLE CORAZON
OCEANSIDE CA
92057-8509
US
IV. Provider business mailing address
1604 FORD AVE STE 11
MODESTO CA
95350-4655
US
V. Phone/Fax
- Phone: 209-840-1624
- Fax:
- Phone: 209-840-1624
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225XP0200X |
| Taxonomy | Pediatric Occupational Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2251P0200X |
| Taxonomy | Pediatric Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PATIANE
FREITAS
Title or Position: CEO
Credential: DPT
Phone: 209-840-1624