Individual
KIMBERLY DAWN MANZANO DOCTOLERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7313 WHITTIER AVE, WHITTIER, CA 90602-1132
(424) 442-9129
(310) 943-3821
Mailing address
12433 RIVERSIDE DR APT 2, VALLEY VILLAGE, CA 91607-3564
(702) 340-6356
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
247200000X
Other Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
83-1142000
—
CA
Enumeration date
07/29/2016
Last updated
02/14/2022
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