Individual
JUSTIN BAETIONG TALAVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
17275 LASSEN ST, NORTHRIDGE, CA 91325-1956
(818) 294-4707
Mailing address
17275 LASSEN ST, NORTHRIDGE, CA 91325-1956
(818) 294-4707
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
21254
CA
Other
Enumeration date
02/09/2022
Last updated
02/09/2022
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