Individual
MS. ANNA LISA MATUDIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
180 GRAND AVE, SUITE 300, OAKLAND, CA 94612-3741
(510) 835-2131
Mailing address
2033 NUNES DR, SAN JOSE, CA 95131-2626
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
11757
CA
Other
Enumeration date
11/01/2012
Last updated
11/01/2012
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