Provider Demographics
NPI:1336556471
Name:ABLOLA, GENEVIEVE DELGADO (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:GENEVIEVE
Middle Name:DELGADO
Last Name:ABLOLA
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2349 HAMPSTEAD WAY
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92139-2929
Mailing Address - Country:US
Mailing Address - Phone:619-434-3948
Mailing Address - Fax:
Practice Address - Street 1:2349 HAMPSTEAD WAY
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92139-2929
Practice Address - Country:US
Practice Address - Phone:619-434-3948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-21
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1441224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant