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NPI Code Detail

MEDICARE: MRS. SANDRA SIMON OTR/L, CHT

MEDICARE:  MRS. SANDRA  SIMON  OTR/L, CHT
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
1225XH1200XHand Occupational Therapist4403CA

General Provider Information

NPI Number : 1902242878
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SANDRA SIMON OTR/L, CHT
Provider Business Mailing Address
First Line : 2168 S ATLANTIC BLVD
Second Line : # 317
City : MONTEREY PARK
State : CA
Zip : 91754-6839
Country : US
Telephone Number : 323-605-2145
Fax Number :
Provider Business Practice Location Address
First Line : 1823 PENNSYLVANIA AVE
Second Line : APARTMENT C
City : LOS ANGELES
State : CA
Zip : 90033-2430
Country : US
Telephone Number : 323-605-2145
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2013
Last Update Date : 11/22/2021

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Directions to “ MRS. SANDRA SIMON OTR/L, CHT” Practice Location

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