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General NPI Number Information
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NPI Number | 1609692110
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Entity Type | Individual
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Provider Name | WENDY APRIL PHILLIPS OTD, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 11/29/2024
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Last Update Date | 11/29/2024
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Provider Practice Location Address
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Address Line | 18 COMMERCIAL BLVD STE 6
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City | NOVATO
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State | CA
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Zip | 94949-6120
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Country | US
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Telephone | 415-320-1329
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Fax | 415-729-1780
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Provider Business Mailing Address
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Address Line | 260 W BALTIMORE AVE
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City | LARKSPUR
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State | CA
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Zip | 94939-2126
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Country | US
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Telephone | 415-342-8697
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 4210
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License Number State | CA
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