Individual
TALIA M BENTIVENGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
28991 OLD TOWN FRONT ST STE 101, TEMECULA, CA 92590-2858
(951) 556-8157
(951) 414-6060
Mailing address
28991 OLD TOWN FRONT ST STE 101, TEMECULA, CA 92590-2858
(951) 556-8157
(951) 414-6060
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5358
CA
Other
Enumeration date
08/24/2020
Last updated
09/20/2021
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