Individual
JOANN (JODY) EILEEN TATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.,OTR/L
Contact information
Practice address
12881 KNOTT ST STE 103, GARDEN GROVE, CA 92841-3939
(714) 892-6828
(714) 898-9720
Mailing address
12881 KNOTT ST STE 103, GARDEN GROVE, CA 92841-3939
(714) 892-6828
(714) 898-9720
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
05584
MD
225XP0200X
Pediatric Occupational Therapist
Primary
10825
CA
Other
Enumeration date
04/15/2009
Last updated
01/12/2011
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