Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 4252 | CA |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 4252 | CA |
Y | 225XP0200X | Occupational Therapist - Pediatrics | 4252 | CA |
NPI | 1487847653 |
---|---|
Provider Name | Ms. Priya Siva |
First Address | Los Angeles, CA 90066-7429 |
Second Address | Los Angeles, CA 90066-7429 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2007 |
Last Update Date | 22/08/2007 |