Healthcare Provider Details
I. General information
NPI: 1760343040
Provider Name (Legal Business Name): VALENTIN BACANI ALICANTE OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/18/2025
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3680 E IMPERIAL HWY STE 305
LYNWOOD CA
90262-2659
US
IV. Provider business mailing address
4550 LINCOLN AVE UNIT 214
CYPRESS CA
90630-2645
US
V. Phone/Fax
- Phone: 310-220-6108
- Fax: 310-220-6109
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | 26501 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: