Provider Demographics
NPI:1700408747
Name:BORJA, LORNA (OTR/L)
Entity Type:Individual
Prefix:
First Name:LORNA
Middle Name:
Last Name:BORJA
Suffix:
Gender:F
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 1:14510 SAN DIEGUITO DR
Mailing Address - Street 2:
Mailing Address - City:LA MIRADA
Mailing Address - State:CA
Mailing Address - Zip Code:90638-4326
Mailing Address - Country:US
Mailing Address - Phone:310-613-6811
Mailing Address - Fax:
Practice Address - Street 1:14510 SAN DIEGUITO DR
Practice Address - Street 2:
Practice Address - City:LA MIRADA
Practice Address - State:CA
Practice Address - Zip Code:90638-4326
Practice Address - Country:US
Practice Address - Phone:310-613-6811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-13
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4637225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist