Individual
MRS. JUDITH WOLF IVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
5998 PILGRIM AVE, SAN JOSE, CA 95129-4729
(408) 252-9086
Mailing address
5998 PILGRIM AVE, SAN JOSE, CA 95129-4729
(408) 252-9086
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT 3233
CA
Other
Enumeration date
10/13/2005
Last updated
07/08/2007
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