Basic Information
Provider Information
NPI: 1881864064
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ABRIS LIMAS
FirstName: MAJELLA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: OT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 823 GATEWAY CENTER WAY
Address2:  
City: SAN DIEGO
State: CA
PostalCode: 921024541
CountryCode: US
TelephoneNumber: 6195152300
FaxNumber: 6192342447
Practice Location
Address1: 823 GATEWAY CENTER WAY
Address2:  
City: SAN DIEGO
State: CA
PostalCode: 921024541
CountryCode: US
TelephoneNumber: 6195152300
FaxNumber: 6192342447
Other Information
ProviderEnumerationDate: 03/04/2008
LastUpdateDate: 03/04/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X4424CAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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