Provider Demographics
NPI:1922276757
Name:MCCAGHEY DELANEY, TARA ANN (OTR)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:ANN
Last Name:MCCAGHEY DELANEY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7884 JON WAY
Mailing Address - Street 2:
Mailing Address - City:GRANITE BAY
Mailing Address - State:CA
Mailing Address - Zip Code:95746-6928
Mailing Address - Country:US
Mailing Address - Phone:916-947-3289
Mailing Address - Fax:
Practice Address - Street 1:6960 DESTINY DR
Practice Address - Street 2:STE 117
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95677-2993
Practice Address - Country:US
Practice Address - Phone:916-947-3289
Practice Address - Fax:916-791-7776
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-14
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5080225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist