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Individual

CHANELLE SOER BAUTISTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
620 SAND HILL RD, PALO ALTO, CA 94304-2002
(855) 916-5814
Mailing address
2456 DRIFTWOOD WAY, SAN LEANDRO, CA 94577-6516
(510) 456-8634

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
25733
CA

Other

Enumeration date
11/27/2023
Last updated
12/01/2023
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