Individual
MR. JOSEPH EVARISTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
2957 BLAZING STAR DR, THOUSAND OAKS, CA 91362-1756
(818) 415-3466
Mailing address
2957 BLAZING STAR DR, THOUSAND OAKS, CA 91362-1756
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2549
CA
Other
Enumeration date
02/12/2007
Last updated
07/08/2007
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