1144482845 NPI number — NAOMI JUNE MANNING OCCUPATIONAL THERAPY

Table of content: NAOMI JUNE MANNING OCCUPATIONAL THERAPY (NPI 1144482845)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144482845 NPI number — NAOMI JUNE MANNING OCCUPATIONAL THERAPY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MANNING
Provider First Name:
NAOMI
Provider Middle Name:
JUNE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
OCCUPATIONAL THERAPY
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
STEWART
Provider Other First Name:
NAOMI
Provider Other Middle Name:
JUNE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
OCCUPATIONAL THERAPY
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1144482845
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/25/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7801 RUSH RIVER DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SACRAMENTO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95831-4602
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
916-428-2113
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7801 RUSH RIVER DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SACRAMENTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95831-4602
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-428-2113
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/25/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225X00000X , with the licence number:  6763 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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