Individual
EDITH VILLAGOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
585 NUT TREE CT, VACAVILLE, CA 95687-3353
(707) 449-8081
Mailing address
1300 BURTON DR APT 221, VACAVILLE, CA 95687-3534
(916) 519-1321
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5826
CA
Other
Enumeration date
11/05/2021
Last updated
11/05/2021
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