Provider Demographics
NPI:1689305179
Name:PECHA, EVA THERESE (OTR)
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:THERESE
Last Name:PECHA
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 1:1354 MT PISGAH RD # 203
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-6907
Mailing Address - Country:US
Mailing Address - Phone:916-337-3725
Mailing Address - Fax:
Practice Address - Street 1:1354 MT PISGAH RD # 203
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-6907
Practice Address - Country:US
Practice Address - Phone:916-337-3725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-23
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23709225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA23709OtherDEPARTMENT OF CONSUMER AFFAIRS
469940OtherNATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY