Individual
MS. STACI L RAYGOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
17318 SAN LUIS ST.. #3, FOUNTAIN VALLEY, CA 92708
(714) 963-3770
Mailing address
17318 SAN LUIS ST.. #3, FOUNTAIN VALLEY, CA 92708
(714) 963-3770
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA 1233
CA
Other
Enumeration date
05/01/2007
Last updated
07/08/2007
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