Justine Carandang, OTR/L
Individual provider Active NPI Occupational Therapist · Glen Ellen, CA
NPI 1891165064 · NPPES record last updated Sep 18, 2024
Key facts
- NPI
- 1891165064
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 12798 (CA)
- Practice address
- 5139 Warm Springs Rd Unit a
Glen Ellen, CA 95442-8754 - Phone
- (551) 587-3773
- NPI assigned
- Sep 30, 2015
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12798 | CA | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 12798 | CA | Yes |
Addresses
Primary practice location
5139 Warm Springs Rd Unit a
Glen Ellen, CA 95442-8754
Mailing address
5139 Warm Springs Rd Unit a
Glen Ellen, CA 95442-8754
Phone (551) 587-3773
Other providers in Glen Ellen, CA
- Rebeca Fiske Bailey
- BBG Transport Inc
- Jonathan Alan Brouillard
- Angie Denbeste
- Claire Gallagher
- Ann Elizabeth Kottler
- Cheryl Larson
- Cathleen Leonard
All providers in Glen Ellen, CA · Occupational Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 18, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.