Healthcare Provider Details

I. General information

NPI: 1942530407
Provider Name (Legal Business Name): INTEGRATED THERAPY SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2010
Last Update Date: 09/23/2022
Certification Date: 09/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4455 W. 117TH ST. 4TH FL.
HAWTHORNE CA
90250
US

IV. Provider business mailing address

4455 W. 117TH ST. 4TH FL.
HAWTHORNE CA
90250-2241
US

V. Phone/Fax

Practice location:
  • Phone: 310-838-1552
  • Fax: 310-838-1553
Mailing address:
  • Phone: 310-838-1552
  • Fax: 310-838-1553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number34685
License Number StateCA
# 5
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: SHARMILA QUENIMHERR
Title or Position: CLINICAL DIRECTOR
Credential: SLP
Phone: 310-838-1552