Provider Demographics
NPI:1104104363
Name:MAU, MINNIE
Entity type:Individual
Prefix:
First Name:MINNIE
Middle Name:
Last Name:MAU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:743 PINTAIL DR
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95688-2651
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1940 WEBSTER ST
Practice Address - Street 2:STE. 203
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-2920
Practice Address - Country:US
Practice Address - Phone:510-525-2700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-21
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand