Provider Demographics
NPI:1619299237
Name:OSES, MARIA SUSANA (OTL)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:SUSANA
Last Name:OSES
Suffix:
Gender:F
Credentials:OTL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8473 S VAN NESS AVE
Mailing Address - Street 2:#102
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90305-1519
Mailing Address - Country:US
Mailing Address - Phone:323-751-2300
Mailing Address - Fax:323-751-2309
Practice Address - Street 1:8473 S VAN NESS AVE
Practice Address - Street 2:#102
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90305-1519
Practice Address - Country:US
Practice Address - Phone:323-751-2300
Practice Address - Fax:323-751-2309
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-23
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3884225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist