Provider Demographics
NPI:1710579032
Name:SADANGSAL, DIOSELLE (OTR/L)
Entity Type:Individual
Prefix:
First Name:DIOSELLE
Middle Name:
Last Name:SADANGSAL
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 1:9439 ALDABRA CT
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-2102
Mailing Address - Country:US
Mailing Address - Phone:858-848-4459
Mailing Address - Fax:
Practice Address - Street 1:9439 ALDABRA CT
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92129-2102
Practice Address - Country:US
Practice Address - Phone:858-848-4459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-08
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21574225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist