Provider Demographics
NPI:1780064550
Name:MARSH, ANNA M (OTD, OTR/L)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:M
Last Name:MARSH
Suffix:
Gender:F
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 1:2621 JANIS CIR
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-3028
Mailing Address - Country:US
Mailing Address - Phone:858-692-1768
Mailing Address - Fax:
Practice Address - Street 1:2621 JANIS CIR
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-3028
Practice Address - Country:US
Practice Address - Phone:858-692-1768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-05
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15128225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist