Provider Demographics
NPI:1497209217
Name:OCCUPATIONAL THERAPY TRAINING PROGRAM SAN FRANCISCO
Entity Type:Organization
Organization Name:OCCUPATIONAL THERAPY TRAINING PROGRAM SAN FRANCISCO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:AN
Authorized Official - Middle Name:
Authorized Official - Last Name:VUONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-551-0975
Mailing Address - Street 1:425 DIVISADERO ST STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-2242
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:425 DIVISADERO ST STE 300
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-2242
Practice Address - Country:US
Practice Address - Phone:415-551-0975
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-10
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16087252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency