Individual
MRS. NANCY C LAVINE-ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR,L
Contact information
Practice address
6160 MISSION GORGE RD, SUITE# 305, SAN DIEGO, CA 92120-3410
(619) 528-4081
(619) 528-4026
Mailing address
5320 WELLESLEY ST, LA MESA, CA 91942-4446
(619) 528-4081
(619) 528-4026
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
0T3155
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT3155
OT LICENSE
CA
Enumeration date
02/27/2007
Last updated
07/08/2007
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