Individual
SUSAN GERALDINE INABA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1565 GLEN OAKS BLVD, PASADENA, CA 91105-1008
(626) 376-5265
Mailing address
1565 GLEN OAKS BLVD, PASADENA, CA 91105-1008
(626) 376-5265
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
8374
CA
225XE0001X
Environmental Modification Occupational Therapist
Primary
8374
CA
225XG0600X
Gerontology Occupational Therapist
8374
CA
Other
Enumeration date
03/28/2023
Last updated
03/28/2023
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