Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OTA1493 | CA |
NPI | 1013224088 |
---|---|
Provider Name | Mrs. Katrina Angela Nunez I |
First Address | Aliso Viejo, CA 92656-2661 |
Second Address | Anaheim, CA 92805-3733 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/09/2010 |
Last Update Date | 10/09/2010 |