Individual
NICOLE MASTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
41743 ENTERPRISE CIR N, 106, TEMECULA, CA 92590-5645
(951) 302-0278
Mailing address
41743 ENTERPRISE CIR N, 106, TEMECULA, CA 92590-5645
(951) 302-0278
Taxonomy
Speciality
Code
Description
License number
State
225XN1300X
Neurorehabilitation Occupational Therapist
Primary
16193
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16193
CALIFORNIA OT LICENSE
CA
Enumeration date
12/08/2016
Last updated
12/08/2016
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