Provider Demographics
NPI:1750681805
Name:LESIN, RACHEL SHOSHANA (OTR/L CHT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:SHOSHANA
Last Name:LESIN
Suffix:
Gender:F
Credentials:OTR/L CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14624 SHERMAN WAY
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-2241
Mailing Address - Country:US
Mailing Address - Phone:818-902-2888
Mailing Address - Fax:
Practice Address - Street 1:14624 SHERMAN WAY
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-2241
Practice Address - Country:US
Practice Address - Phone:818-902-2888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-22
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC011533225X00000X
CA11384225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist