Individual
MRS. KRISTINE KIKUYE TANITA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
4650 W SUNSET BLVD, LOS ANGELES, CA 90027-6062
(323) 669-2118
Mailing address
2447 HIGHLAND AVE, ALTADENA, CA 91001-2550
(323) 669-2118
(323) 663-0093
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
1744
CA
Other
Enumeration date
03/21/2007
Last updated
07/08/2007
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