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General NPI Number Information
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NPI Number | 1427188838
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Entity Type | Individual
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Provider Name | GINA MIA DI GRAZIA OTR/L, COMS, CLVT
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Gender | Female
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 01/14/2016
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Provider Practice Location Address
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Address Line | 165 1/2 CHATTANOOGA ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94114-3438
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Country | US
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Telephone | 415-846-6266
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Fax |
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Provider Business Mailing Address
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Address Line | 165 1/2 CHATTANOOGA ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94114-3438
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Country | US
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Telephone | 415-846-6266
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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 | 225CX0006X
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Taxonomy Name | Orientation and Mobility Training Rehabilitation Counselor
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License Number | AVCREP CERT. 4898
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT5361
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 225XL0004X
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Taxonomy Name | Low Vision Occupational Therapist
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License Number | OT 5361
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License Number State | CA
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