Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 012592-1 | NY |
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 10147 | CA |
NPI | 1053533927 |
---|---|
Provider Name | Sheila Pia Dequina |
First Address | Los Angeles, CA 90006-2207 |
Second Address | Los Angeles, CA 90006-2207 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2007 |
Last Update Date | 20/04/2020 |