MEDICARE: MRS. JOAN MARIE RICHTER 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
1	225X00000X	Occupational Therapist	OT1810	CA

General Provider Information

NPI Number	:	1942369038
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JOAN MARIE RICHTER OTR

Provider Business Mailing Address
First Line	:	30771 SLOAN CANYON RD
Second Line	:
City	:	CASTAIC
State	:	CA
Zip	:	91384-3444
Country	:	US
Telephone Number	:	661-294-7991
Fax Number	:	661-799-9871

Provider Business Practice Location Address
First Line	:	23929 MCBEAN PKWY
Second Line	:
City	:	VALENCIA
State	:	CA
Zip	:	91355-4466
Country	:	US
Telephone Number	:	661-799-8623
Fax Number	:	661-799-9871

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

Provider Enumeration Date	:	12/06/2006
Last Update Date	:	07/08/2007

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