Healthcare Provider Details

I. General information

NPI: 1356977110
Provider Name (Legal Business Name): ALLISON MARIE UYEKAWA OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2020
Last Update Date: 04/22/2024
Certification Date: 04/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6160 CORNERSTONE CT E STE 100
SAN DIEGO CA
92121-3724
US

IV. Provider business mailing address

4037 AIDAN CIR
CARLSBAD CA
92008-3592
US

V. Phone/Fax

Practice location:
  • Phone: 858-304-6440
  • Fax:
Mailing address:
  • Phone: 951-237-4190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number26040
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: