MEDICARE: LISA SAYO MA OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	7942	CA

General Provider Information

NPI Number	:	1568836831
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA SAYO MA OTR/L

Provider Business Mailing Address
First Line	:	15944 LOS SERRANOS COUNTRY CLUB DR
Second Line	:
City	:	CHINO HILLS
State	:	CA
Zip	:	91709-3993
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	15944 LOS SERRANOS COUNTRY CLUB DR
Second Line	:
City	:	CHINO HILLS
State	:	CA
Zip	:	91709-3993
Country	:	US
Telephone Number	:	818-326-0606
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/23/2015
Last Update Date	:	02/27/2022

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