MEDICARE: MRS. MARLENE ANNE LAMAR O.T.R.,C.H.T.

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
1	2251H1200X	Hand Physical Therapist	OT 3013	CA
2	225X00000X	Occupational Therapist	OT3013	CA

General Provider Information

NPI Number	:	1346341260
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARLENE ANNE LAMAR O.T.R.,C.H.T.

Provider Business Mailing Address
First Line	:	2350 W EL CAMINO REAL FL 2
Second Line	:
City	:	MOUNTAIN VIEW
State	:	CA
Zip	:	94040-6203
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1085 W EL CAMINO REAL
Second Line	:
City	:	SUNNYVALE
State	:	CA
Zip	:	94087-1030
Country	:	US
Telephone Number	:	408-523-3060
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	05/20/2019

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