Individual
JANE MARDELETTE LIM OBENIETA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
4000 CIVIC CENTER DR STE 300, SAN RAFAEL, CA 94903-4129
(628) 877-0040
Mailing address
2840 CHANNEL REEF AVE, TULARE, CA 93274-7509
(559) 361-1816
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
17644
CA
Other
Enumeration date
02/27/2020
Last updated
02/27/2020
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