Individual
BUENAVENTURA PERALTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
1950 S MOUNTAIN AVE, ONTARIO, CA 91762-6723
(909) 983-0084
Mailing address
9200 MILLIKEN AVE APT 7114, RANCHO CUCAMONGA, CA 91730-8511
(909) 528-2355
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
4236
CA
225X00000X
Occupational Therapist
Primary
26834
CA
Other
Enumeration date
10/07/2020
Last updated
10/09/2024
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