Provider Demographics
NPI:1427134972
Name:ZIPP, AMY (MS OT/L)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:ZIPP
Suffix:
Gender:F
Credentials:MS OT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7311 GALILEE RD STE 175
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-7209
Mailing Address - Country:US
Mailing Address - Phone:530-601-9729
Mailing Address - Fax:530-746-0657
Practice Address - Street 1:7311 GALILEE RD STE 175
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-7209
Practice Address - Country:US
Practice Address - Phone:530-601-9729
Practice Address - Fax:530-746-0657
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA8402225XP0200X
225X00000X, 225XN1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
1558953893OtherTYPE 2 NPI
CA1689606469OtherPHYSICAL EDGE, INC.