Provider Demographics
NPI:1326202011
Name:COASTAL HAND AND OCCUPATIONAL THERAPY
Entity Type:Organization
Organization Name:COASTAL HAND AND OCCUPATIONAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHLOE
Authorized Official - Middle Name:
Authorized Official - Last Name:OVERTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-922-1724
Mailing Address - Street 1:650 ALAMO PINTADO DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SOLVANG
Mailing Address - State:CA
Mailing Address - Zip Code:93463
Mailing Address - Country:US
Mailing Address - Phone:805-686-4642
Mailing Address - Fax:805-686-4642
Practice Address - Street 1:201 N COLLEGE DR
Practice Address - Street 2:SUITE 203
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-4614
Practice Address - Country:US
Practice Address - Phone:805-922-1724
Practice Address - Fax:805-922-2765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-11
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT6494171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty