Individual
REBECCA PROSSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1932 14TH ST, SANTA MONICA, CA 90404-4605
(310) 344-2276
Mailing address
1932 14TH ST, SANTA MONICA, CA 90404-4605
(310) 344-2276
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
17722
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17722
CBOT LICENCE NUMBER
CA
01
—
388008
NBCOT LICENCE NUMBER
—
Enumeration date
12/14/2017
Last updated
12/14/2017
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