Basic Information
| Provider Information | |||||||||
| NPI: | 1609341270 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DE LA TORRE | ||||||||
| FirstName: | PATRICIA | ||||||||
| MiddleName: | LORENA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10218 PARISE DR | ||||||||
| Address2: | |||||||||
| City: | WHITTIER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 906041140 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5628963451 | ||||||||
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| Practice Location | |||||||||
| Address1: | 12411 SLAUSON AVE STE H | ||||||||
| Address2: | |||||||||
| City: | WHITTIER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 906062835 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5626935449 | ||||||||
| FaxNumber: | 5626935469 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/09/2018 | ||||||||
| LastUpdateDate: | 10/09/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 224Z00000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant |
No ID Information.