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General NPI Number Information
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NPI Number | 1447717756
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Entity Type | Individual
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Provider Name | BRANDY MARIE SACCACIO OTR/L MSOT
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Gender | Female
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Dates
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Enumeration Date | 02/22/2019
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Last Update Date | 02/22/2019
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Provider Practice Location Address
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Address Line | 760 WESTWOOD PLZ # B7-435G
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City | LOS ANGELES
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State | CA
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Zip | 90095-8353
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Country | US
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Telephone | 310-825-0161
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Fax |
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Provider Business Mailing Address
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Address Line | 5660 SATURN ST
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City | LOS ANGELES
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State | CA
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Zip | 90019-3840
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT15384
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License Number State | CA
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