Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant | 7299 | CA |
Y | 225X00000X | Occupational Therapist | 7299 | CA |
N | 225XF0002X | Feeding, Eating & Swallowing |
NPI | 1083987499 |
---|---|
Provider Name | Aviril Sepulveda |
First Address | Sherman Oaks, CA 91401-4613 |
Second Address | Sherman Oaks, CA 91423-2296 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2012 |
Last Update Date | 21/05/2021 |