Individual
NOELLE BAKKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
725 WELCH RD, 3RD FLOOR, PALO ALTO, CA 94304-1601
(650) 497-8643
Mailing address
725 WELCH RD, 3RD FLOOR, PALO ALTO, CA 94304-1601
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
15600
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
053305
—
CA
Enumeration date
10/20/2015
Last updated
10/20/2015
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