Provider Demographics
NPI:1083964167
Name:STOSICK, SHEILA KITSON (MS, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:KITSON
Last Name:STOSICK
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3253 JUDY LN
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-4707
Mailing Address - Country:US
Mailing Address - Phone:925-935-7356
Mailing Address - Fax:925-946-1167
Practice Address - Street 1:3253 JUDY LN
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-4707
Practice Address - Country:US
Practice Address - Phone:925-935-7356
Practice Address - Fax:925-946-1167
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-14
Last Update Date:2015-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACBOT 6490174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist