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General NPI Number Information
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NPI Number | 1841923901
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Entity Type | Individual
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Provider Name | NICOLE ANN SALAZAR ANIAG COTA/L
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Gender | Female
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Dates
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Enumeration Date | 07/06/2022
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Last Update Date | 07/06/2022
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Provider Practice Location Address
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Address Line | 7320 FIRESTONE BLVD STE 105
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City | DOWNEY
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State | CA
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Zip | 90241-4159
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Country | US
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Telephone | 562-927-5820
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Fax |
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Provider Business Mailing Address
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Address Line | 817 W BEVERLY BLVD STE 201
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City | MONTEBELLO
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State | CA
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Zip | 90640-4265
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Country | US
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Telephone | 562-927-5820
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OTA5967
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License Number State | CA
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