Provider Demographics
NPI:1740301647
Name:AASLAND, BETSY ANN (MS, OTR)
Entity type:Individual
Prefix:
First Name:BETSY
Middle Name:ANN
Last Name:AASLAND
Suffix:
Gender:F
Credentials:MS, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 VIA CALLEJON STE B
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92673-6264
Mailing Address - Country:US
Mailing Address - Phone:949-498-5100
Mailing Address - Fax:949-366-5665
Practice Address - Street 1:1120 VIA CALLEJON STE B
Practice Address - Street 2:
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92673-6264
Practice Address - Country:US
Practice Address - Phone:949-498-5100
Practice Address - Fax:949-366-5665
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6019225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1025653OtherNBCOT CERTIFICATION
CA6019OtherSTATE LICENSE NUMBER