MEDICARE: BRENDA TOLENTINO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	28416	CA

General Provider Information

NPI Number	:	1639752819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDA TOLENTINO

Provider Business Mailing Address
First Line	:	221 N SAN DIMAS AVE # 219
Second Line	:
City	:	SAN DIMAS
State	:	CA
Zip	:	91773-2664
Country	:	US
Telephone Number	:	909-519-8912
Fax Number	:

Provider Business Practice Location Address
First Line	:	221 N SAN DIMAS AVE # 219
Second Line	:
City	:	SAN DIMAS
State	:	CA
Zip	:	91773-2664
Country	:	US
Telephone Number	:	909-519-8912
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2021
Last Update Date	:	01/02/2026

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Directions to “ BRENDA TOLENTINO ” Practice Location

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