Provider Demographics
NPI:1518600634
Name:NUNEZ ARIAS, AMIR (COTA/L)
Entity Type:Individual
Prefix:
First Name:AMIR
Middle Name:
Last Name:NUNEZ ARIAS
Suffix:
Gender:M
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 1:6701 E AVENUE R4
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93552-4123
Mailing Address - Country:US
Mailing Address - Phone:747-272-2700
Mailing Address - Fax:
Practice Address - Street 1:6701 E AVENUE R4
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93552-4123
Practice Address - Country:US
Practice Address - Phone:747-272-2700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-16
Last Update Date:2022-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5790224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant