Organization
COAST ALLIED HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MOLLIE CHAINANI BIVENS MOT, OTR/L (PRESIDENT/OWNER)
(805) 996-0899
Entity
Organization
Contact information
Practice address
805 AEROVISTA PL STE 101, SAN LUIS OBISPO, CA 93401-7921
(805) 996-0899
(805) 250-3089
Mailing address
805 AEROVISTA PL STE 101, SAN LUIS OBISPO, CA 93401-7921
(805) 996-0899
(805) 250-3089
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OT8048
CA
225XP0200X
Pediatric Occupational Therapist
Primary
OT8048
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT8048
OTHER
CA
Enumeration date
04/16/2014
Last updated
12/09/2022
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