Individual
ANDRE PRYSTUPA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
16500 VENTURA BLVD STE 414, ENCINO, CA 91436-5050
(818) 788-1003
Mailing address
16500 VENTURA BLVD STE 414, ENCINO, CA 91436-5050
(818) 788-1003
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
6524
CA
Other
Enumeration date
11/29/2023
Last updated
11/29/2023
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