Provider Demographics
NPI:1740406834
Name:WESTERMAN, CAROL (OT)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:WESTERMAN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 HIGHWAY 101 SOUTH
Mailing Address - Street 2:SUITE B
Mailing Address - City:CRESCENT CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95531
Mailing Address - Country:US
Mailing Address - Phone:707-465-6110
Mailing Address - Fax:707-464-7845
Practice Address - Street 1:555 HIGHWAY 101 SOUTH
Practice Address - Street 2:SUITE B
Practice Address - City:CRESCENT CITY
Practice Address - State:CA
Practice Address - Zip Code:95531
Practice Address - Country:US
Practice Address - Phone:707-464-6110
Practice Address - Fax:707-464-7845
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAA549790174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAA549790Medicare PIN