Provider Demographics
NPI:1417785106
Name:ZANDERS, VANNESSA LAIGO (OTR)
Entity type:Individual
Prefix:
First Name:VANNESSA
Middle Name:LAIGO
Last Name:ZANDERS
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 1:27701 COLDSPRINGS PL
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91354-1446
Mailing Address - Country:US
Mailing Address - Phone:626-372-9656
Mailing Address - Fax:
Practice Address - Street 1:7100 VAN NUYS BLVD STE 103
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-3063
Practice Address - Country:US
Practice Address - Phone:310-504-3135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15170225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist