Healthcare Provider Details

I. General information

NPI: 1427385533
Provider Name (Legal Business Name): JESELYN OUANO DELGADO OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2009
Last Update Date: 06/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12411 SLAUSON AVENUE UNIT H
WHITTIER CA
90606
US

IV. Provider business mailing address

25220 BELLE PORTE AVE UNIT 4
HARBOR CITY CA
90710-2847
US

V. Phone/Fax

Practice location:
  • Phone: 562-693-5449
  • Fax: 562-693-5469
Mailing address:
  • Phone: 310-920-5232
  • Fax: 562-693-5469

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code225XE0001X
TaxonomyEnvironmental Modification Occupational Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: