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General NPI Number Information
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NPI Number | 1760260434
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Entity Type | Organization
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Legal Business Name | PEDIATRICS THERAPY CLINIC AN OCCUPATIONAL THERAPY PC
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Dates
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Enumeration Date | 09/15/2023
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Last Update Date | 09/15/2023
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Provider Practice Location Address
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Address Line | 402 S PROSPECTORS RD STE I
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City | DIAMOND BAR
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State | CA
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Zip | 91765-1618
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Country | US
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Telephone | 415-264-6625
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Fax |
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Provider Business Mailing Address
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Address Line | 402 S PROSPECTORS RD STE I
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City | DIAMOND BAR
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State | CA
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Zip | 91765-1618
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Country | US
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Telephone | 415-264-6625
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KATHERINE CATAPANG
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Credential | OTR, L
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Telephone | 909-896-2334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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