MEDICARE: AMALIA OPAL IOLANI ABROJENA

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	225400000X	Rehabilitation Practitioner

General Provider Information

NPI Number	:	1669669735
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMALIA OPAL IOLANI ABROJENA

Provider Business Mailing Address
First Line	:	PO BOX 2077
Second Line	:
City	:	UKIAH
State	:	CA
Zip	:	95482-2077
Country	:	US
Telephone Number	:	707-467-2010
Fax Number	:

Provider Business Practice Location Address
First Line	:	810 N STATE ST
Second Line	:
City	:	UKIAH
State	:	CA
Zip	:	95482-3410
Country	:	US
Telephone Number	:	707-462-7267
Fax Number	:

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

Provider Enumeration Date	:	10/02/2007
Last Update Date	:	04/14/2023

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