Provider Demographics
NPI:1851432280
Name:MONTANA REHABILITATION THERAPY
Entity Type:Organization
Organization Name:MONTANA REHABILITATION THERAPY
Other - Org Name:CALIFORNIA HAND THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:MCKAY
Authorized Official - Last Name:BOTTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-604-1924
Mailing Address - Street 1:2001 SOLAR DR
Mailing Address - Street 2:SUITE 215
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-2645
Mailing Address - Country:US
Mailing Address - Phone:805-604-1924
Mailing Address - Fax:805-604-0176
Practice Address - Street 1:940 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-5331
Practice Address - Country:US
Practice Address - Phone:805-614-4879
Practice Address - Fax:805-614-6113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT3863225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ65055ZOtherBLUE SHIELD
CACT3946350Medicaid
CAW15755Medicare ID - Type UnspecifiedMEDICARE