Individual
MS. MONICA M PETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
24492 CASTELO CIR, MISSION VIEJO, CA 92691-5005
(949) 951-1528
Mailing address
24492 CASTELO CIR, MISSION VIEJO, CA 92691-5005
(949) 951-1528
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2039
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2039
—
CA
Enumeration date
10/21/2011
Last updated
10/21/2011
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