Provider Demographics
NPI:1548775927
Name:BICK, AMY BETH (COTA/L)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:BETH
Last Name:BICK
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7840 MISSION CENTER CT STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-1320
Mailing Address - Country:US
Mailing Address - Phone:619-692-0622
Mailing Address - Fax:619-692-0644
Practice Address - Street 1:7840 MISSION CENTER CT STE 200
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-1320
Practice Address - Country:US
Practice Address - Phone:619-692-0622
Practice Address - Fax:619-692-0644
Is Sole Proprietor?:No
Enumeration Date:2017-12-07
Last Update Date:2017-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOTA4190224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant