Provider Demographics
NPI:1083202097
Name:ROMERO, ZAIDA LIZETH (COTA/L)
Entity Type:Individual
Prefix:
First Name:ZAIDA
Middle Name:LIZETH
Last Name:ROMERO
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9945 LURLINE AVE APT 201
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-4662
Mailing Address - Country:US
Mailing Address - Phone:661-932-3797
Mailing Address - Fax:
Practice Address - Street 1:3557 CAMPUS DR
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-2744
Practice Address - Country:US
Practice Address - Phone:714-882-9038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5382224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant