Provider Demographics
NPI:1184043739
Name:ROSENBERG, NANCY LIM (OTR)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:LIM
Last Name:ROSENBERG
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:985 YALE DR
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:CA
Mailing Address - Zip Code:94010-7440
Mailing Address - Country:US
Mailing Address - Phone:650-703-1723
Mailing Address - Fax:650-325-2107
Practice Address - Street 1:985 YALE DR
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:CA
Practice Address - Zip Code:94010-7440
Practice Address - Country:US
Practice Address - Phone:650-703-1723
Practice Address - Fax:650-325-2107
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-10
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 6917225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist