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NPI Code Detail

MEDICARE: ANNABELLE RILEY BEWICKE

MEDICARE: ANNABELLE RILEY BEWICKE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225XP0200XPediatric Occupational Therapist17287CA

General Provider Information

NPI Number : 1093224651
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNABELLE RILEY BEWICKE
Provider Business Mailing Address
First Line : 21 SILK OAK CIR
Second Line :
City : SAN RAFAEL
State : CA
Zip : 94901-8301
Country : US
Telephone Number : 14154972157
Fax Number :
Provider Business Practice Location Address
First Line : 751 ALAMEDA DE LAS PULGAS
Second Line :
City : BELMONT
State : CA
Zip : 94002-1606
Country : US
Telephone Number : 415-497-2157
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2017
Last Update Date : 03/17/2018

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Directions to “ ANNABELLE RILEY BEWICKE ” Practice Location

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