Healthcare Provider Details

I. General information

NPI: 1396532479
Provider Name (Legal Business Name): LARISSA ARAKAKI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2025
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11000 NEW FALCON WAY
CERRITOS CA
90703-1552
US

IV. Provider business mailing address

5776 BRAZIL DR
BUENA PARK CA
90620-1209
US

V. Phone/Fax

Practice location:
  • Phone: 562-402-8389
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License NumberOT25496
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: