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Individual

ANGELA DAWN ERVIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTRE

Contact information

Practice address
2530 PROFESSIONAL PKWY, SANTA MARIA, CA 93455-1602
(805) 928-4465
(805) 928-7935
Mailing address
2530 PROFESSIONAL PKWY, SANTA MARIA, CA 93455-1602
(805) 928-4465
(805) 928-7935

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT5937
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
CT0059370
CA
01
OT0059370
BLUE SHIELD
CA
Enumeration date
01/02/2007
Last updated
07/08/2007
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