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General NPI Number Information
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NPI Number | 1215336805
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Entity Type | Organization
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Legal Business Name | DR. STEPHANIE FOSTER, PHD, OTR/L
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Dates
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Enumeration Date | 08/19/2014
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Last Update Date | 08/19/2014
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Provider Practice Location Address
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Address Line | 652 WILDFLOWER DR
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City | SANTA MARIA
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State | CA
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Zip | 93455-6099
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Country | US
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Telephone | 805-264-1553
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Fax | 949-215-4281
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Provider Business Mailing Address
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Address Line | PO BOX 2476
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City | ORCUTT
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State | CA
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Zip | 93457-2476
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Country | US
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Telephone | 805-264-1553
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Fax | 949-215-4281
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Authorized Official
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Title or Position | ACCOUNT MANAGER
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Name | MELINDA PELOQUIN
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Credential |
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Telephone | 949-215-5008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XF0002X
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Taxonomy Name | Feeding, Eating & Swallowing Occupational Therapist
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License Number | OT3616
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OT3616
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP20089
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License Number State | CA
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