Individual
DIANA DISTOR VALENZUELA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
915 CRENSHAW BLVD, LOS ANGELES, CA 90019-1938
(323) 937-5466
Mailing address
2318 S ARTESIA ST, SANTA ANA, CA 92704-4710
(714) 425-2267
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2937
CA
Other
Enumeration date
01/02/2015
Last updated
01/02/2015
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