Healthcare Provider Details

I. General information

NPI: 1558293365
Provider Name (Legal Business Name): LETITIA ALOYSIUS
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3122 CRESCENT AVE APT 6
MARINA CA
93933-3172
US

IV. Provider business mailing address

3122 CRESCENT AVE APT 6
MARINA CA
93933-3172
US

V. Phone/Fax

Practice location:
  • Phone: 254-981-1532
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOTL36764
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: