Provider Demographics
NPI:1356680193
Name:CREMONA-THOMPSON, VENET (OT/L)
Entity Type:Individual
Prefix:
First Name:VENET
Middle Name:
Last Name:CREMONA-THOMPSON
Suffix:
Gender:F
Credentials:OT/L
Other - Prefix:
Other - First Name:VENET
Other - Middle Name:
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OT/L
Mailing Address - Street 1:1034 OAK GROVE RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94518-3225
Mailing Address - Country:US
Mailing Address - Phone:925-681-4450
Mailing Address - Fax:
Practice Address - Street 1:1034 OAK GROVE RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94518-3225
Practice Address - Country:US
Practice Address - Phone:925-681-4450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-13
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 481225XF0002X, 225XM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XM0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistMental Health
No225XF0002XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistFeeding, Eating & Swallowing