Provider Demographics
NPI:1760504146
Name:DHANAK, MINAL (OTR)
Entity Type:Individual
Prefix:
First Name:MINAL
Middle Name:
Last Name:DHANAK
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6340 VARIEL AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-2514
Mailing Address - Country:US
Mailing Address - Phone:818-888-4559
Mailing Address - Fax:
Practice Address - Street 1:6340 VARIEL AVE
Practice Address - Street 2:SUITE A
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-2514
Practice Address - Country:US
Practice Address - Phone:818-888-4559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 9058225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist