Individual
REBECA R PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA OT
Contact information
Practice address
15454 GALE AVE, SUITE F, HACIENDA HEIGHTS, CA 91745-1500
(626) 330-1538
Mailing address
23659 GOLD NUGGET AVE, DIAMOND BAR, CA 91765-2336
(909) 837-8176
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
12766
CA
Other
Enumeration date
01/02/2013
Last updated
01/02/2013
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