Organization
TINY TRIUMPHS PEDIATRIC OT
Active
Organization
TINY TRIUMPHS PEDIATRIC OT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ZAIRA PENALOZA MS, OTR/L (CEO)
(323) 402-3626
Entity
Organization
Contact information
Practice address
1045 S PINE ST, SAN GABRIEL, CA 91776-3136
(323) 402-3626
Mailing address
1613 CHELSEA RD STE 844, SAN MARINO, CA 91108-2419
(626) 289-0102
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Enumeration date
09/09/2024
Last updated
09/09/2024
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