Healthcare Provider Details

I. General information

NPI: 1184991861
Provider Name (Legal Business Name): BABY STEPS THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2011
Last Update Date: 07/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6960 DESTINY DR SUITE 112
ROCKLIN CA
95677-2993
US

IV. Provider business mailing address

6960 DESTINY DR SUITE 112
ROCKLIN CA
95677-2993
US

V. Phone/Fax

Practice location:
  • Phone: 916-415-0119
  • Fax: 916-415-0120
Mailing address:
  • Phone: 916-415-0119
  • Fax: 916-415-0120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-13-15014
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number41663
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number30173
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT5080
License Number StateCA
# 5
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT8522
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number12482
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number11987
License Number StateCA
# 8
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number9365
License Number StateCA
# 9
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number14203
License Number StateCA
# 10
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number13892
License Number StateCA
# 11
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number9704
License Number StateCA
# 12
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP14076
License Number StateCA
# 13
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number21754
License Number StateCA
# 14
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number22420
License Number StateCA
# 15
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number20839
License Number StateCA

VIII. Authorized Official

Name: MR. WILLIAM DELANEY
Title or Position: CFO
Credential:
Phone: 916-764-0119