Provider Demographics
NPI:1447417977
Name:CUSHMAN-PERKINS, MARCIA ANNE (OTR)
Entity Type:Individual
Prefix:MS
First Name:MARCIA
Middle Name:ANNE
Last Name:CUSHMAN-PERKINS
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 1:9312 GUYS GULCH RD
Mailing Address - Street 2:
Mailing Address - City:YREKA
Mailing Address - State:CA
Mailing Address - Zip Code:96097-9731
Mailing Address - Country:US
Mailing Address - Phone:530-598-2310
Mailing Address - Fax:530-436-2340
Practice Address - Street 1:9312 GUYS GULCH RD
Practice Address - Street 2:
Practice Address - City:YREKA
Practice Address - State:CA
Practice Address - Zip Code:96097-9731
Practice Address - Country:US
Practice Address - Phone:530-598-2310
Practice Address - Fax:530-436-2340
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4615225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACT3023490OtherCA MEDICAL