Individual
DAX GANZON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OT R/L
Contact information
Practice address
8421 STARLILY CT, ELK GROVE, CA 95758-1321
(310) 346-2529
Mailing address
8421 STARLILY CT, ELK GROVE, CA 95758-1321
(310) 346-2529
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT 8552
CA
225XG0600X
Gerontology Occupational Therapist
—
—
225XM0800X
Mental Health Occupational Therapist
—
—
225XN1300X
Neurorehabilitation Occupational Therapist
—
—
225XP0019X
Physical Rehabilitation Occupational Therapist
—
—
Other
Enumeration date
03/27/2014
Last updated
03/27/2014
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