Organization
STOCKTON HAND THERAPY & REHABILITATION
Active
Other names
Stockton Hand Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARIANNE RENEE CABALLERO-RODRIGUEZ OT/L, CHT (PRESIDENT)
(209) 956-8737
Entity
Organization
Contact information
Practice address
1919 GRAND CANAL BLVD, SUITE C4, STOCKTON, CA 95207-8114
(209) 956-8737
(209) 956-2586
Mailing address
7824 SOUTHWORTH RD, VALLEY SPRINGS, CA 95252-8971
(209) 956-8737
(209) 956-2586
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
2470
CA
225X00000X
Occupational Therapist
2470
CA
225XH1200X
Hand Occupational Therapist
Primary
2470
CA
225XN1300X
Neurorehabilitation Occupational Therapist
2470
CA
335E00000X
Prosthetic/Orthotic Supplier
2470
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1172170
FIRST HEALTH
CA
01
—
171713600
DEPARTMENT OF LABOR
CA
01
—
5530198
AETNA
CA
01
—
P00066568
MEDICARE RAILROAD
CA
01
—
ZZZ07989Z
BLUE SHIELD GROUP
CA
Enumeration date
08/13/2006
Last updated
09/23/2009
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