Individual
CONCIANA ERVIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
275 W HOSPITALITY LN STE 103, SAN BERNARDINO, CA 92408-3238
(561) 402-0469
Mailing address
11202 SAN JUAN ST, LOMA LINDA, CA 92354-3216
(561) 402-0469
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
21899
CA
Other
Enumeration date
04/08/2021
Last updated
11/13/2023
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