Provider Demographics
NPI:1801043526
Name:TSHABALALA, MANEO BARBARA (OTR)
Entity Type:Individual
Prefix:MS
First Name:MANEO
Middle Name:BARBARA
Last Name:TSHABALALA
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 1:27520 ENTERPRISE CIR W
Mailing Address - Street 2:STE. B
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-4828
Mailing Address - Country:US
Mailing Address - Phone:951-587-6405
Mailing Address - Fax:
Practice Address - Street 1:27520 ENTERPRISE CIR W
Practice Address - Street 2:STE. B
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-4828
Practice Address - Country:US
Practice Address - Phone:951-587-6405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-25
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT2862225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist