Organization
LITTLE LEGACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA LONTAYO M.S. OTR/L, CBIS (OWNER)
(858) 397-4300
Entity
Organization
Contact information
Practice address
16885 W BERNARDO DR STE 107, SAN DIEGO, CA 92127-1619
(858) 397-4300
Mailing address
16885 W BERNARDO DR STE 107, SAN DIEGO, CA 92127-1619
(858) 397-4300
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
09/09/2025
Last updated
09/09/2025
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