Individual
CHARISSE VINZELLE NACITO IMATONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1209 HEMLOCK WAY, SANTA ANA, CA 92707-3609
(714) 546-1966
Mailing address
8831 1/2 RAMONA ST, BELLFLOWER, CA 90706-6334
(310) 847-9227
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA4402
CA
Other
Enumeration date
11/08/2021
Last updated
11/08/2021
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