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NPI Code Detail

MEDICARE: ROXANNE JANINE MONIZ OTR/L

MEDICARE: ROXANNE JANINE MONIZ OTR/L
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
1225X00000XOccupational Therapist4268CA
2225XP0019XPhysical Rehabilitation Occupational Therapist4268CA
3225XP0200XPediatric Occupational Therapist4268CA

General Provider Information

NPI Number : 1295057404
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROXANNE JANINE MONIZ OTR/L
Provider Business Mailing Address
First Line : 4400 ALMA AVE
Second Line :
City : CASTRO VALLEY
State : CA
Zip : 94546-3104
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4400 ALMA AVE
Second Line :
City : CASTRO VALLEY
State : CA
Zip : 94546-3104
Country : US
Telephone Number : 510-000-0000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2010
Last Update Date : 12/22/2010

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