Provider Demographics
NPI:1407318322
Name:GALEANA, JEANINE (COTA/L)
Entity Type:Individual
Prefix:
First Name:JEANINE
Middle Name:
Last Name:GALEANA
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 1:3760 CAROL WAY
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91977-1041
Mailing Address - Country:US
Mailing Address - Phone:619-997-4671
Mailing Address - Fax:
Practice Address - Street 1:3760 CAROL WAY
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91977-1041
Practice Address - Country:US
Practice Address - Phone:619-997-4671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-01
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant