Provider Demographics
NPI:1629323233
Name:KUO, ZHEZHI (COTA/L)
Entity Type:Individual
Prefix:
First Name:ZHEZHI
Middle Name:
Last Name:KUO
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 1:2044 REDDING AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-3529
Mailing Address - Country:US
Mailing Address - Phone:714-523-5812
Mailing Address - Fax:
Practice Address - Street 1:1601 S BALDWIN AVE
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-7930
Practice Address - Country:US
Practice Address - Phone:323-681-1501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-19
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2686224Z00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program