Provider Demographics
NPI:1831481845
Name:PEARSON, ELIZABETH TATE (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:TATE
Last Name:PEARSON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7249 ORO COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95966-9331
Mailing Address - Country:US
Mailing Address - Phone:530-534-5043
Mailing Address - Fax:
Practice Address - Street 1:1633 CYPRESS LN
Practice Address - Street 2:
Practice Address - City:PARADISE
Practice Address - State:CA
Practice Address - Zip Code:95969-2823
Practice Address - Country:US
Practice Address - Phone:530-877-9316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-09
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3457225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist