Healthcare Provider Details

I. General information

NPI: 1194058644
Provider Name (Legal Business Name): ELIZABETH KAFKA ESCARZEGA OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2009
Last Update Date: 09/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 8TH AVENUE SUITE 207
SAN FRANCISCO CA
94118
US

IV. Provider business mailing address

402 8TH AVENUE SUITE 207
SAN FRANCISCO CA
94118
US

V. Phone/Fax

Practice location:
  • Phone: 415-831-4263
  • Fax: 415-831-4269
Mailing address:
  • Phone: 415-831-4263
  • Fax: 415-831-4269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT8990
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: