Provider Demographics
NPI:1891424453
Name:HOMAN, CHRISTINE (MOT)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:HOMAN
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2118 SAN RAFAEL AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-1610
Mailing Address - Country:US
Mailing Address - Phone:925-984-4978
Mailing Address - Fax:
Practice Address - Street 1:2118 SAN RAFAEL AVE
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-1610
Practice Address - Country:US
Practice Address - Phone:408-673-7750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-08
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist