Individual
ESMERALDA CASILLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
4959 PALO VERDE ST, SUITE 101A, MONTCLAIR, CA 91763-2331
(909) 624-6878
Mailing address
14343 QUAIL CT, FONTANA, CA 92336-3627
(909) 355-1188
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
OT 4001
CA
225XF0002X
Feeding, Eating & Swallowing Occupational Therapist
OT 4001
CA
225XP0200X
Pediatric Occupational Therapist
Primary
OT 4001
CA
Other
Enumeration date
09/14/2010
Last updated
09/14/2010
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