Provider Demographics
NPI:1184013476
Name:PADILLA, ADRIENNE JOYCE
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:JOYCE
Last Name:PADILLA
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ADRIENNE
Other - Middle Name:JOYCE
Other - Last Name:PADILLA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR/L
Mailing Address - Street 1:505 N LA BREA AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-2015
Mailing Address - Country:US
Mailing Address - Phone:323-937-4860
Mailing Address - Fax:
Practice Address - Street 1:505 N LA BREA AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-2015
Practice Address - Country:US
Practice Address - Phone:323-937-4860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-09
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13719225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist