Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 20234 | CA |
NPI | 1629679337 |
---|---|
Provider Name | Celeste Li |
First Address | Arcadia, CA 91007-7954 |
Second Address | Arcadia, CA 91007-7954 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2020 |
Last Update Date | 08/11/2020 |