Individual
CARMELA GRACE DIZON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. OTR/L
Contact information
Practice address
822 ANTOINETTE LN APT D, SOUTH SAN FRANCISCO, CA 94080-3375
(650) 504-2413
Mailing address
822 ANTOINETTE LN APT D, SOUTH SAN FRANCISCO, CA 94080-3375
(650) 504-2413
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
24521
CA
Other
Enumeration date
10/31/2023
Last updated
10/31/2023
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