Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 22251 | CA |
NPI | 1043891393 |
---|---|
Provider Name | Cassandra Maxine Machia |
First Address | Sherman Oaks, CA 91423-1063 |
Second Address | Santa Monica, CA 90404-4605 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2021 |
Last Update Date | 19/04/2021 |