Provider Demographics
NPI:1982627949
Name:REHABILITATION AND OCCUPATIONAL CONSULTANTS
Entity Type:Organization
Organization Name:REHABILITATION AND OCCUPATIONAL CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:916-983-5611
Mailing Address - Street 1:1635 CREEKSIDE DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-3830
Mailing Address - Country:US
Mailing Address - Phone:916-983-5611
Mailing Address - Fax:916-983-5615
Practice Address - Street 1:1635 CREEKSIDE DR
Practice Address - Street 2:SUITE 101
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-3830
Practice Address - Country:US
Practice Address - Phone:916-983-5611
Practice Address - Fax:916-983-5615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16050225100000X
CA26357225100000X
CA123182251E1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No2251E1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistErgonomicsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ23025ZMedicare ID - Type Unspecified