Individual
BRENDA JOHANSON VINNICOMBE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2014 CHURTON AVE, LOS ALTOS, CA 94024-6905
(650) 967-7190
(650) 967-7841
Mailing address
2014 CHURTON AVE, LOS ALTOS, CA 94024-6905
(650) 967-7190
(650) 967-7841
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT10816
CA
Other
Enumeration date
03/25/2010
Last updated
03/25/2010
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