Provider Demographics
NPI:1356321707
Name:DROUIN, LISANE (OT)
Entity Type:Individual
Prefix:
First Name:LISANE
Middle Name:
Last Name:DROUIN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 TORINO DR
Mailing Address - Street 2:APARTMENT 4
Mailing Address - City:SAN CARLOS
Mailing Address - State:CA
Mailing Address - Zip Code:94070-2857
Mailing Address - Country:US
Mailing Address - Phone:650-594-1410
Mailing Address - Fax:
Practice Address - Street 1:620 SAND HILL RD
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-2002
Practice Address - Country:US
Practice Address - Phone:650-853-5028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2063225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist