Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 12759 | CA |
NPI | 1043561871 |
---|---|
Provider Name | Miss Frances Montesa |
First Address | Ontario, CA 91764-1647 |
Second Address | Hacienda Heights, CA 91745-1500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2012 |
Last Update Date | 19/09/2012 |