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General NPI Number Information
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NPI Number | 1659383925
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Entity Type | Individual
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Provider Name | MARIANNE RENEE CABALLERO-RODRIGUEZ OT/L, CHT
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Gender | Female
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 10/24/2012
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Provider Practice Location Address
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Address Line | 1919 GRAND CANAL BLVD SUITE C-4
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City | STOCKTON
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State | CA
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Zip | 95207-8114
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Country | US
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Telephone | 209-956-8737
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Fax | 209-956-2586
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Provider Business Mailing Address
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Address Line | 7824 SOUTHWORTH RD
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City | VALLEY SPRINGS
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State | CA
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Zip | 95252-8971
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Country | US
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Telephone | 209-763-2528
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Fax | 209-763-2947
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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 | 225000000X
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Taxonomy Name | Orthotic Fitter
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License Number | 2470
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License Number State | CA
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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 | 2470
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 225XH1200X
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Taxonomy Name | Hand Occupational Therapist
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License Number | 2470
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 225XN1300X
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Taxonomy Name | Neurorehabilitation Occupational Therapist
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License Number | 2470
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License Number State | CA
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