Healthcare Provider Details

I. General information

NPI: 1053564088
Provider Name (Legal Business Name): MARIA JOANNA ROMUALDEZ LUCIANO OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2008
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3045 SANTIAGO ST
SAN FRANCISCO CA
94116-1526
US

IV. Provider business mailing address

363 MONTICELLO ST
SAN FRANCISCO CA
94132-2635
US

V. Phone/Fax

Practice location:
  • Phone: 415-759-2222
  • Fax:
Mailing address:
  • Phone: 646-321-6203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number17615
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: