Provider Demographics
NPI:1457921256
Name:TREFZ, PARKER (OT)
Entity type:Individual
Prefix:
First Name:PARKER
Middle Name:
Last Name:TREFZ
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4660 SPYRES WAY
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95356-9804
Mailing Address - Country:US
Mailing Address - Phone:209-578-3290
Mailing Address - Fax:209-550-4944
Practice Address - Street 1:4660 SPYRES WAY
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95356-9804
Practice Address - Country:US
Practice Address - Phone:209-578-3290
Practice Address - Fax:209-550-4944
Is Sole Proprietor?:No
Enumeration Date:2021-06-25
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT21248225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist