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NPI Code Detail

MEDICARE: ANN ANDERSON OTR

MEDICARE: ANN ANDERSON OTR
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 Therapist13285CA

General Provider Information

NPI Number : 1730501321
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANN ANDERSON OTR
Provider Business Mailing Address
First Line : 343 WILLOW GREEN CT
Second Line :
City : VACAVILLE
State : CA
Zip : 95687-4319
Country : US
Telephone Number : 707-322-9175
Fax Number :
Provider Business Practice Location Address
First Line : 585 NUT TREE CT
Second Line :
City : VACAVILLE
State : CA
Zip : 95687-3353
Country : US
Telephone Number : 707-449-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/15/2014
Last Update Date : 01/15/2014

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Directions to “ ANN ANDERSON OTR” Practice Location

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