Healthcare Provider Details

I. General information

NPI: 1942953781
Provider Name (Legal Business Name): BINITA TIWARI OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2022
Last Update Date: 05/19/2022
Certification Date: 05/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 A ST APT 1806
SAN DIEGO CA
92101-4558
US

IV. Provider business mailing address

801 A ST APT 1806
SAN DIEGO CA
92101-4558
US

V. Phone/Fax

Practice location:
  • Phone: 619-618-5611
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number15533
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: