Provider Demographics
NPI:1457075392
Name:DOROJA, JANESS ANDREI FUENTES (OTA)
Entity Type:Individual
Prefix:MRS
First Name:JANESS ANDREI
Middle Name:FUENTES
Last Name:DOROJA
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6716 VINELAND AVE APT 305
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-2070
Mailing Address - Country:US
Mailing Address - Phone:818-821-9511
Mailing Address - Fax:
Practice Address - Street 1:3557 CAMPUS DR
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-2744
Practice Address - Country:US
Practice Address - Phone:805-241-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOTA6141224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant