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General NPI Number Information
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NPI Number | 1992048797
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Entity Type | Individual
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Provider Name | TERRI ELAINE NISHIMURA MA, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 03/29/2013
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Last Update Date | 03/29/2013
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Provider Practice Location Address
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Address Line | 1815 W 213TH ST STE 100
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City | TORRANCE
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State | CA
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Zip | 90501-2852
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Country | US
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Telephone | 310-328-0276
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Fax |
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Provider Business Mailing Address
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Address Line | 23235 GRANT AVE
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City | TORRANCE
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State | CA
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Zip | 90505-3557
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Country | US
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Telephone | 310-375-2801
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 3593
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License Number State | CA
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