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General NPI Number Information
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NPI Number | 1902242878
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Entity Type | Individual
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Provider Name | SANDRA SIMON OTR/L, CHT
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Gender | Female
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Dates
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Enumeration Date | 05/17/2013
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Last Update Date | 11/22/2021
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Provider Practice Location Address
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Address Line | 1823 PENNSYLVANIA AVE APARTMENT C
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City | LOS ANGELES
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State | CA
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Zip | 90033-2430
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Country | US
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Telephone | 323-605-2145
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Fax |
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Provider Business Mailing Address
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Address Line | 2168 S ATLANTIC BLVD # 317
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City | MONTEREY PARK
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State | CA
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Zip | 91754-6839
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Country | US
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Telephone | 323-605-2145
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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 | 225XH1200X
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Taxonomy Name | Hand Occupational Therapist
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License Number | 4403
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License Number State | CA
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