Individual
KEKONA JAZMIN NUEZCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1149 W 190TH ST STE 2300, GARDENA, CA 90248-4350
(310) 892-5812
Mailing address
1149 W 190TH ST STE 2300, GARDENA, CA 90248-4350
(310) 892-5812
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
7158
CA
Other
Enumeration date
05/07/2025
Last updated
05/07/2025
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