Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XL0004X | Low Vision | 2232 | CA |
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 2232 | CA |
NPI | 1063175529 |
---|---|
Provider Name | Maria L. Cruz |
First Address | Colton, CA 92324-9231 |
Second Address | Colton, CA 92324-9231 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2021 |
Last Update Date | 20/10/2021 |