Provider Demographics
NPI:1851408504
Name:ANDERSON OCCUPATIONAL THERAPY
Entity Type:Organization
Organization Name:ANDERSON OCCUPATIONAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST, OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:ROTHSTEIN
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:530-570-1985
Mailing Address - Street 1:PO BOX 6345
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95927-6345
Mailing Address - Country:US
Mailing Address - Phone:530-570-1985
Mailing Address - Fax:530-899-0366
Practice Address - Street 1:572 RIO LINDO AVENUE
Practice Address - Street 2:SUITE 104
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-1851
Practice Address - Country:US
Practice Address - Phone:530-570-1985
Practice Address - Fax:530-899-0366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT1148225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ03910ZMedicare PIN