Individual
JEANETTE DELA CRUZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
16428 BALLINGER ST, NORTH HILLS, CA 91343-1804
(818) 404-6824
(818) 404-6824
Mailing address
16428 BALLINGER ST, NORTH HILLS, CA 91343-1804
(818) 404-6824
(818) 404-6824
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
424022
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
224Z00000X
GENESIS REHAB
CA
Enumeration date
08/08/2019
Last updated
04/07/2024
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