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Individual

JENNIE LAUREL TOMIKO ETO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, OTR/L

Contact information

Practice address
8600 W 3RD ST, SUITE 3B, LOS ANGELES, CA 90048-3338
(310) 275-2130
Mailing address
8600 W. 3RD STREET, SUITE 3B, LOS ANGELES, CA 90048
(310) 275-2130
(310) 275-2131

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
12090
CA
225XH1200X
Hand Occupational Therapist
Primary
OT12090
CA

Other

Enumeration date
09/06/2011
Last updated
05/16/2017
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