Healthcare Provider Details

I. General information

NPI: 1700781747
Provider Name (Legal Business Name): CHARISSE ALIMAGNO LVN, COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21414 S VERMONT AVE
TORRANCE CA
90502-1935
US

IV. Provider business mailing address

12141 CENTRALIA ST UNIT 304
LAKEWOOD CA
90715-1566
US

V. Phone/Fax

Practice location:
  • Phone: 310-320-8714
  • Fax: 310-320-8714
Mailing address:
  • Phone: 424-364-8144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number4044
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: