Provider Demographics
NPI:1174645543
Name:GOLD, FLORENCE (OT)
Entity Type:Individual
Prefix:MRS
First Name:FLORENCE
Middle Name:
Last Name:GOLD
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:FLORENCE
Other - Middle Name:
Other - Last Name:GORDON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:16973 STARDUST PL
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-1732
Mailing Address - Country:US
Mailing Address - Phone:818-832-7368
Mailing Address - Fax:818-832-7249
Practice Address - Street 1:10605 BALBOA BLVD
Practice Address - Street 2:SUITE 330
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-6342
Practice Address - Country:US
Practice Address - Phone:818-832-7368
Practice Address - Fax:818-832-7249
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2234225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist