Doctor Name: | CURTIS CRAIG OTA |
NPI Number: | 1114214947 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CAADE |
License Number: | 081965 |
Business Practice Address: | 306 Spruce Ave South San Francisco, CA - 940802741 |
Business Phone Number: | 6505899305 |
Business Fax Number: | 6505899330 |
Mailing Address: | 733 27th Ave, SAN MATEO |
State: | CA |
Postal Code: | 944032604 |
Phone Number: | 6505157297 |
Fax Number: | |
NPI Enumeration Date: | 06/30/2011 |
NPI Last Update Date: | 06/30/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 081965 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |