Provider Demographics
NPI:1649084740
Name:TRAN, CHRISTINE DOAN (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:DOAN
Last Name:TRAN
Suffix:
Gender:
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:667 LIGHTHOUSE AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:PACIFIC GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:93950-2666
Mailing Address - Country:US
Mailing Address - Phone:831-318-0558
Mailing Address - Fax:831-603-6061
Practice Address - Street 1:667 LIGHTHOUSE AVE STE 201
Practice Address - Street 2:
Practice Address - City:PACIFIC GROVE
Practice Address - State:CA
Practice Address - Zip Code:93950-2666
Practice Address - Country:US
Practice Address - Phone:831-318-0558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-07
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27415225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist