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General NPI Number Information
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NPI Number | 1942006655
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Entity Type | Individual
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Provider Name | ELLA MCDONALD MOT OTR/L
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Gender | Female
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Dates
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Enumeration Date | 02/22/2025
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 12647 ALCOSTA BLVD STE 100
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City | SAN RAMON
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State | CA
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Zip | 94583-4439
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Country | US
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Telephone | 925-210-8503
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Fax |
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Provider Business Mailing Address
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Address Line | 572 WILD ROSE LN
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City | IMPERIAL
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State | CA
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Zip | 92251-8945
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Country | US
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Telephone | 760-457-1716
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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 | 225XH1200X
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Taxonomy Name | Hand Occupational Therapist
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License Number | 27475
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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 | 27475
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License Number State | CA
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