Individual
GRACE MARIKO NAKATSUKASA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2051 MARENGO ST, LOS ANGELES, CA 90033-1352
(323) 409-7437
Mailing address
2051 MARENGO ST, LOS ANGELES, CA 90033-1352
(323) 409-7437
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3709
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3709
CA OTA LICENSE
CA
Enumeration date
11/16/2018
Last updated
11/16/2018
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