Individual
LISA WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5426 HOMESIDE AVE, LOS ANGELES, CA 90016-3712
(323) 839-7453
Mailing address
5426 HOMESIDE AVE, LOS ANGELES, CA 90016-3712
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
870
CA
Other
Enumeration date
01/08/2015
Last updated
01/08/2015
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