Provider Demographics
NPI:1265873822
Name:CONCENTRA
Entity type:Organization
Organization Name:CONCENTRA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTANA SAMER
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:415-621-5055
Mailing Address - Street 1:2 CONNECTICUT ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-2451
Mailing Address - Country:US
Mailing Address - Phone:415-621-5055
Mailing Address - Fax:
Practice Address - Street 1:2 CONNECTICUT ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94107-2451
Practice Address - Country:US
Practice Address - Phone:415-625-5055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-11
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12867261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation