MEDICARE: MRS. VICTORIA LINDSAY WARD MS, 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
1	101Y00000X	Counselor
2	225X00000X	Occupational Therapist	14528	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	14528	OTHER	CA	CBOT

General Provider Information

NPI Number	:	1376802660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. VICTORIA LINDSAY WARD MS, OTR/L

Provider Business Mailing Address
First Line	:	2505 W SHAW AVE BLDG A
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93711-3334
Country	:	US
Telephone Number	:	559-228-9100
Fax Number	:	559-432-8055

Provider Business Practice Location Address
First Line	:	2505 W SHAW AVE BLDG A
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93711-3334
Country	:	US
Telephone Number	:	559-228-9100
Fax Number	:	559-432-8055

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

Provider Enumeration Date	:	05/08/2012
Last Update Date	:	05/10/2018

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