Individual
KAZUMI IKEDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1115 S SUNSET AVE, WEST COVINA, CA 91790-3940
(626) 962-4011
Mailing address
12435 W JEFFERSON BLVD, APT 102, LOS ANGELES, CA 90066-6974
(510) 798-4143
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
664
CA
Other
Enumeration date
04/27/2013
Last updated
04/27/2013
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