MEDICARE: ARLENE D GRONNINGSATER O.T.

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	225X00000X	Occupational Therapist	OT8438	CA

General Provider Information

NPI Number	:	1841246519
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARLENE D GRONNINGSATER O.T.

Provider Business Mailing Address
First Line	:	3465 SACRAMENTO ST
Second Line	:	APT. 9
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94118-1941
Country	:	US
Telephone Number	:	860-539-6862
Fax Number	:

Provider Business Practice Location Address
First Line	:	1801 BUSH ST
Second Line	:	#30
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94109-5239
Country	:	US
Telephone Number	:	415-351-0716
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	07/08/2007

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