Provider Demographics
NPI:1316557010
Name:CAALAMAN, KATRINA DIANDRA MENDOZA (OTR/L)
Entity Type:Individual
Prefix:
First Name:KATRINA DIANDRA
Middle Name:MENDOZA
Last Name:CAALAMAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13563 ESSENCE RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-4721
Mailing Address - Country:US
Mailing Address - Phone:858-229-7459
Mailing Address - Fax:
Practice Address - Street 1:500 E VALLEY PKWY
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-3054
Practice Address - Country:US
Practice Address - Phone:760-737-5110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-06
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19131225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist