Individual
MS. ROBIN DEROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR,CHT,CVE
Contact information
Practice address
7120 HAYVENHURST AVE STE 215, VAN NUYS, CA 91406-3813
(818) 785-9515
(818) 785-9535
Mailing address
7120 HAYVENHURST AVE STE 215, VAN NUYS, CA 91406-3813
(818) 785-9515
(818) 785-9535
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
OT950
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
954370043
TAX ID #
CA
Enumeration date
04/06/2007
Last updated
06/11/2013
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