Individual
JORGE PERALTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
2505 W POMONA ST, SANTA ANA, CA 92704-4050
(714) 296-0695
Mailing address
2505 W POMONA ST, SANTA ANA, CA 92704-4050
(714) 296-0695
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1979
CA
Other
Enumeration date
01/06/2015
Last updated
01/06/2015
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