Provider Demographics
NPI:1518611565
Name:PRECIADO, SEHILA E (COTA/L)
Entity Type:Individual
Prefix:
First Name:SEHILA
Middle Name:E
Last Name:PRECIADO
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 1:14033 BURBANK BLVD APT 103
Mailing Address - Street 2:
Mailing Address - City:VALLEY GLEN
Mailing Address - State:CA
Mailing Address - Zip Code:91401-5071
Mailing Address - Country:US
Mailing Address - Phone:818-965-9707
Mailing Address - Fax:
Practice Address - Street 1:7335 VAN NUYS BLVD STE 118
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-1951
Practice Address - Country:US
Practice Address - Phone:310-553-2695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4033225X00000X, 224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty