Healthcare Provider Details

I. General information

NPI: 1568538064
Provider Name (Legal Business Name): CAPUCHINO THERAPY GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 01/04/2024
Certification Date: 01/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 MARCONI AVE
SACRAMENTO CA
95821-5309
US

IV. Provider business mailing address

1015 RILEY STREET #6268
FOLSOM CA
95630-6268
US

V. Phone/Fax

Practice location:
  • Phone: 916-481-1300
  • Fax: 916-365-9870
Mailing address:
  • Phone: 916-481-1300
  • Fax: 916-365-9870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT40045
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2084
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code225XF0002X
TaxonomyFeeding, Eating & Swallowing Occupational Therapist
License NumberOT2084
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License NumberOT2084
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT2084
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code225XR0403X
TaxonomyDriving and Community Mobility Occupational Therapist
License NumberOT2084
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License NumberOT2084
License Number StateCA
# 8
Primary TaxonomyN
Taxonomy Code2251E1200X
TaxonomyErgonomics Physical Therapist
License NumberPT23114
License Number StateCA
# 9
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP6954
License Number StateCA

VIII. Authorized Official

Name: MS. LULA M CAPUCHINO
Title or Position: PRESIDENT
Credential: OTR/L
Phone: 916-481-1300