Provider Demographics
NPI:1558064451
Name:NOOR, NAZRIAH (COTA)
Entity Type:Individual
Prefix:
First Name:NAZRIAH
Middle Name:
Last Name:NOOR
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 N 3RD ST APT D
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-3493
Mailing Address - Country:US
Mailing Address - Phone:818-390-0903
Mailing Address - Fax:
Practice Address - Street 1:121 N 3RD ST APT D
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-3493
Practice Address - Country:US
Practice Address - Phone:818-390-0903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6297224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant