Provider Demographics
NPI:1043967839
Name:TAO, KATHERINE D (OTR/L)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:D
Last Name:TAO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1321 COLLEGE ST STE E
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95695-4706
Mailing Address - Country:US
Mailing Address - Phone:530-668-1010
Mailing Address - Fax:530-668-9799
Practice Address - Street 1:1321 COLLEGE ST STE E
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-4706
Practice Address - Country:US
Practice Address - Phone:530-668-1010
Practice Address - Fax:530-668-9799
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23245235Z00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist