Provider Demographics
NPI:1770256885
Name:GAUSMAN, CASSIDY LEEANN (OTD, OTR/L)
Entity Type:Individual
Prefix:DR
First Name:CASSIDY
Middle Name:LEEANN
Last Name:GAUSMAN
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 493396
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96049-3396
Mailing Address - Country:US
Mailing Address - Phone:530-221-9952
Mailing Address - Fax:
Practice Address - Street 1:1225 EUREKA WAY # B
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-0815
Practice Address - Country:US
Practice Address - Phone:530-247-1280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22630225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist