Provider Demographics
NPI:1609314525
Name:KAWASHIMA, CRAIG (OTR/L)
Entity Type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:
Last Name:KAWASHIMA
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:MR
Other - First Name:CRAIG
Other - Middle Name:
Other - Last Name:KAWASHIMA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR/L
Mailing Address - Street 1:21868 GARDENVIEW LN
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-1132
Mailing Address - Country:US
Mailing Address - Phone:408-417-0632
Mailing Address - Fax:
Practice Address - Street 1:21868 GARDENVIEW LN
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-1132
Practice Address - Country:US
Practice Address - Phone:408-417-0632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-11
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14526225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist