Provider Demographics
NPI:1871285775
Name:WHITLING, ELIZABETH (MOT, OTR/L)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:WHITLING
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35563 OAK SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:TOLLHOUSE
Mailing Address - State:CA
Mailing Address - Zip Code:93667-9610
Mailing Address - Country:US
Mailing Address - Phone:559-408-4523
Mailing Address - Fax:
Practice Address - Street 1:35563 OAK SPRINGS RD
Practice Address - Street 2:
Practice Address - City:TOLLHOUSE
Practice Address - State:CA
Practice Address - Zip Code:93667-9610
Practice Address - Country:US
Practice Address - Phone:559-408-4523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21514225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist