Individual
ANNIE L BUSTAMANTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1420 S. MILLIKEN AVENUE, SUITE 508, ONTARIO, CA 91761
(909) 988-2418
Mailing address
9027 FERNDALE AVE, FONTANA, CA 92335-6017
(909) 343-7779
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
225XM0800X
Mental Health Occupational Therapist
Primary
28539
CA
Other
Enumeration date
11/10/2019
Last updated
03/10/2026
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