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General NPI Number Information
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NPI Number | 1942053186
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Entity Type | Individual
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Provider Name | REBECCA S LAURITZEN
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Gender | Female
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Dates
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Enumeration Date | 04/08/2024
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 2345 FAIR OAKS BLVD
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City | SACRAMENTO
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State | CA
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Zip | 95825-4708
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Country | US
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Telephone | 916-480-6735
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Fax |
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Provider Business Mailing Address
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Address Line | 4797 REX CT
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City | SACRAMENTO
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State | CA
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Zip | 95822-1821
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Country | US
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Telephone | 435-592-1632
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT60634374
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License Number State | WA
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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 | 27291
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License Number State | CA
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