Provider Demographics
NPI:1477176287
Name:ARIF, SYED B (COTA THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:SYED
Middle Name:B
Last Name:ARIF
Suffix:
Gender:M
Credentials:COTA THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 NORTHBANK CT APT 127
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-7649
Mailing Address - Country:US
Mailing Address - Phone:786-202-5033
Mailing Address - Fax:
Practice Address - Street 1:442 E HAMPTON ST
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95204-5519
Practice Address - Country:US
Practice Address - Phone:209-466-0456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-27
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOTA3617225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation