Provider Demographics
NPI:1437424959
Name:ALONZO-AGUILUS, URITH K (OTR)
Entity Type:Individual
Prefix:
First Name:URITH
Middle Name:K
Last Name:ALONZO-AGUILUS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 RICHMOND DR
Mailing Address - Street 2:
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-3626
Mailing Address - Country:US
Mailing Address - Phone:714-577-8503
Mailing Address - Fax:
Practice Address - Street 1:1421 RICHMOND DR
Practice Address - Street 2:
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-3626
Practice Address - Country:US
Practice Address - Phone:714-577-8503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-16
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT8178225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist