Individual
AUDREY LYNN IBARRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
706 N DIAMOND BAR BLVD STE B, DIAMOND BAR, CA 91765-1059
(909) 396-8900
Mailing address
933 WILLOW AVE, LA PUENTE, CA 91746-1664
(562) 325-7630
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
6402
CA
Other
Enumeration date
05/27/2026
Last updated
05/27/2026
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