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NPI Code Detail

MEDICARE: MS. ELIZABETH TATE PEARSON OTR/L

MEDICARE: MS. ELIZABETH TATE PEARSON 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
1225X00000XOccupational Therapist3457CA

General Provider Information

NPI Number : 1831481845
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ELIZABETH TATE PEARSON OTR/L
Provider Business Mailing Address
First Line : 7249 ORO COUNTRY CLUB RD
Second Line :
City : OROVILLE
State : CA
Zip : 95966-9331
Country : US
Telephone Number : 530-534-5043
Fax Number :
Provider Business Practice Location Address
First Line : 1633 CYPRESS LN
Second Line :
City : PARADISE
State : CA
Zip : 95969-2823
Country : US
Telephone Number : 530-877-9316
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2011
Last Update Date : 05/09/2011

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