Provider Demographics
NPI:1679334239
Name:HURST, EMILY M (OTR/L)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:M
Last Name:HURST
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1703 PALERMO DR
Mailing Address - Street 2:
Mailing Address - City:HUGHSON
Mailing Address - State:CA
Mailing Address - Zip Code:95326-8905
Mailing Address - Country:US
Mailing Address - Phone:209-380-6313
Mailing Address - Fax:
Practice Address - Street 1:1670 FULKERTH RD
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95380-6885
Practice Address - Country:US
Practice Address - Phone:209-380-6313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12593225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist