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NPI Code Detail

MEDICARE: BETSY ANN AASLAND MS, O.T.R.

MEDICARE: BETSY ANN AASLAND MS, O.T.R.
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
1225XP0200XPediatric Occupational Therapist6019CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11025653OTHERCANBCOT CERTIFICATION
26019OTHERCASTATE LICENSE NUMBER

General Provider Information

NPI Number : 1740301647
Entity Type Code : Individual
Provider Name (Legal Business Name) : BETSY ANN AASLAND MS, O.T.R.
Provider Business Mailing Address
First Line : 1120 VIA CALLEJON STE B
Second Line :
City : SAN CLEMENTE
State : CA
Zip : 92673-6264
Country : US
Telephone Number : 949-498-5100
Fax Number : 949-366-5665
Provider Business Practice Location Address
First Line : 1120 VIA CALLEJON STE B
Second Line :
City : SAN CLEMENTE
State : CA
Zip : 92673-6264
Country : US
Telephone Number : 949-498-5100
Fax Number : 949-366-5665
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2007
Last Update Date : 01/10/2012

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