Provider Demographics
NPI:1619674603
Name:KASHANIAN, YEHUDA YONATAN (OTR/L)
Entity Type:Individual
Prefix:MR
First Name:YEHUDA
Middle Name:YONATAN
Last Name:KASHANIAN
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18110 ERWIN ST
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-7153
Mailing Address - Country:US
Mailing Address - Phone:818-270-8135
Mailing Address - Fax:
Practice Address - Street 1:18110 ERWIN ST
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91335-7153
Practice Address - Country:US
Practice Address - Phone:818-270-8135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-10
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23741225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist