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General NPI Number Information
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NPI Number | 1023834355
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Entity Type | Individual
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Provider Name | GABRIELLE PATINO OTR/L
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Gender | Female
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Dates
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Enumeration Date | 12/03/2024
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 2800 BENEDICT DR
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City | SAN LEANDRO
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State | CA
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Zip | 94577-6840
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Country | US
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Telephone | 510-357-8300
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Fax |
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Provider Business Mailing Address
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Address Line | 5 STUART DR W
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City | GLEN COVE
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State | NY
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Zip | 11542-2611
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Country | US
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Telephone | 516-639-9854
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OTH-009738
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License Number State | AZ
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