Provider Demographics
NPI:1851694178
Name:MORANDI, EDYL ROSE TORRECAMPO (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:EDYL ROSE
Middle Name:TORRECAMPO
Last Name:MORANDI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:EDYL ROSE
Other - Middle Name:LOBATON
Other - Last Name:TORRECAMPO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:1236 ERRINGER ROAD
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065
Mailing Address - Country:US
Mailing Address - Phone:262-253-6344
Mailing Address - Fax:
Practice Address - Street 1:980 WARWICK AVE
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-3620
Practice Address - Country:US
Practice Address - Phone:805-307-7300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-08
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9660171W00000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No171W00000XOther Service ProvidersContractor