Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 104100000X | Social Worker | ||
Y | 225X00000X | Occupational Therapist | ||
N | 225XE0001X | Environmental Modification | ||
N | 225XN1300X | Occupational Therapist - Neurorehabilitation |
NPI | 1225414634 |
---|---|
Provider Name | Ms. Samira Mohmand |
First Address | Redondo Beach, CA 90277-0033 |
Second Address | Redondo Beach, CA 90277 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2015 |
Last Update Date | 11/04/2019 |