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Individual

DOUGLAS G FOSCO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MOT, OTR/L, CHT

Contact information

Practice address
3418 LOMA VISTA RD STE A, VENTURA, CA 93003-3015
(805) 765-4773
Mailing address
1518 COFFEE RD STE I, MODESTO, CA 95355-3164
(209) 576-0888

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
056-009640
IL
225X00000X
Occupational Therapist
Primary
18508
CA

Other

Enumeration date
02/07/2012
Last updated
07/02/2021
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