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Individual

ALICE ANN NUSBAUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTL

Contact information

Practice address
2585 JOAN LN, FALLBROOK, CA 92028-9641
(760) 731-0580
Mailing address
2585 JOAN LN, FALLBROOK, CA 92028-9641
(760) 731-0580

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
10892
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10892
CALIFORNIA BOARD OF OCCUPATIONAL THERAPY
CA
Enumeration date
04/05/2011
Last updated
04/05/2011
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