Individual
MARIJANE SWANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/C
Contact information
Practice address
1700 ADAMS AVE, SUITE 103, COSTA MESA, CA 92626-4865
(714) 556-2288
(714) 435-1745
Mailing address
1700 ADAMS AVE, SUITE 103, COSTA MESA, CA 92626-4865
(714) 556-2288
(714) 435-1745
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
1018159
MD
224Z00000X
Occupational Therapy Assistant
Primary
OTA 1592
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1018159
NATIONAL BOARD FOR CERT IN OCCUPATIONAL THERAPY
MD
01
—
OTA 1592
CALIFORNIA BOARD OF OCCUPATIONAL THERAPY
CA
Enumeration date
08/14/2008
Last updated
08/14/2008
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