Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | OT 1262 | CA |
NPI | 1033443890 |
---|---|
Provider Name | Anna-Lorraine Gonzaga Holley |
First Address | Chino Hills, CA 91709-5247 |
Second Address | Hacienda Heights, CA 91745-1500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2009 |
Last Update Date | 13/12/2021 |