MEDICARE: REDWOOD HAND THERAPY INC

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	225XH1200X	Hand Occupational Therapist		CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	DF7890	OTHER	CA	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ZZZ00752Z	OTHER	CA	BLUE SHIELD OF CALIFORNIA

General Provider Information

NPI Number	:	1689673816
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REDWOOD HAND THERAPY INC

Provider Business Mailing Address
First Line	:	320 TESCONI CIR
Second Line	:	SUITE G
City	:	SANTA ROSA
State	:	CA
Zip	:	95401-4611
Country	:	US
Telephone Number	:	707-544-2637
Fax Number	:	707-544-2088

Provider Business Practice Location Address
First Line	:	320 TESCONI CIR
Second Line	:	SUITE G
City	:	SANTA ROSA
State	:	CA
Zip	:	95401-4611
Country	:	US
Telephone Number	:	707-544-2637
Fax Number	:	707-544-2088

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. DONNA B EAKIN
Credential	:	OTR/L, CHT
Telephone Number	:	707-544-2637

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	06/09/2015

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Directions to “REDWOOD HAND THERAPY INC ” Practice Location

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