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NPI Code Detail

MEDICARE: NINA DAVID-NARANJO OT

MEDICARE: NINA DAVID-NARANJO OT
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 Therapist3474CA

General Provider Information

NPI Number : 1609351204
Entity Type Code : Individual
Provider Name (Legal Business Name) : NINA DAVID-NARANJO OT
Provider Business Mailing Address
First Line : 122 GADWALL ST
Second Line :
City : AMERICAN CANYON
State : CA
Zip : 94503-1388
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2200 TUOLUMNE ST
Second Line :
City : VALLEJO
State : CA
Zip : 94589-2523
Country : US
Telephone Number : 707-644-7401
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2018
Last Update Date : 09/28/2018

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