Provider Demographics
NPI:1982991865
Name:GALLO, CHRISTINA M (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:M
Last Name:GALLO
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:M G
Other - Last Name:LYONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3687 MT DIABLO BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-3717
Mailing Address - Country:US
Mailing Address - Phone:925-954-4546
Mailing Address - Fax:925-415-6046
Practice Address - Street 1:3687 MT DIABLO BLVD STE 100
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-3717
Practice Address - Country:US
Practice Address - Phone:925-954-4547
Practice Address - Fax:925-415-6046
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-29
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11034225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist