Individual
FAULA ANNE PENA BORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15107 VANOWEN ST, VAN NUYS, CA 91405-4542
(818) 782-6600
Mailing address
15107 VANOWEN ST, VAN NUYS, CA 91405-4542
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
18021
CA
Other
Enumeration date
02/14/2019
Last updated
02/14/2019
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