Healthcare Provider Details
I. General information
NPI: 1972938744
Provider Name (Legal Business Name): SHERYL YETTO TRAINOR MS, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/11/2013
Last Update Date: 09/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3498 GREEN VALLEY RD
RESCUE CA
95672-9625
US
IV. Provider business mailing address
4030 CHESTNUT LN
PLACERVILLE CA
95667-6736
US
V. Phone/Fax
- Phone: 530-391-8670
- Fax: 888-538-0573
- Phone: 530-306-8487
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225XF0002X |
| Taxonomy | Feeding, Eating & Swallowing Occupational Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225XP0200X |
| Taxonomy | Pediatric Occupational Therapist |
| License Number | 1082 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: