Provider Demographics
NPI:1194196600
Name:DELA CRUZ, MELANIE FLORES (COTA)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:FLORES
Last Name:DELA CRUZ
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10258 DESTINO ST
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-7010
Mailing Address - Country:US
Mailing Address - Phone:562-441-4040
Mailing Address - Fax:
Practice Address - Street 1:10258 DESTINO ST
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-7010
Practice Address - Country:US
Practice Address - Phone:562-441-4040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-09
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3299224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant