Provider Demographics
NPI:1760707442
Name:TROWBRIDGE, TODD CONAN
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:CONAN
Last Name:TROWBRIDGE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:TODD
Other - Middle Name:CONAN
Other - Last Name:TROWBRIDGE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR/L
Mailing Address - Street 1:111 CASTLEFORD CIRCLE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526
Mailing Address - Country:US
Mailing Address - Phone:925-487-6397
Mailing Address - Fax:925-855-1902
Practice Address - Street 1:111 CASTLEFORD CIR
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-3602
Practice Address - Country:US
Practice Address - Phone:925-487-6397
Practice Address - Fax:925-855-1902
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-06
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 1825225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics