Healthcare Provider Details

I. General information

NPI: 1144320953
Provider Name (Legal Business Name): ILSE VIOLETA VARGAS CATINDIG OTRL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7777 NORRIS CANYON RD
SAN RAMON CA
94583-5404
US

IV. Provider business mailing address

2010 EL CAMINO REAL STE 824
SANTA CLARA CA
95050-4051
US

V. Phone/Fax

Practice location:
  • Phone: 925-275-8442
  • Fax:
Mailing address:
  • Phone: 408-917-8125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License NumberOT8914
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License NumberOT 8914
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: