Provider Demographics
NPI:1669897187
Name:BARGIONI, GINA (MS OTR/L)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:BARGIONI
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7266 FRANKLIN AVE
Mailing Address - Street 2:APT 106
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90046-3021
Mailing Address - Country:US
Mailing Address - Phone:530-351-1072
Mailing Address - Fax:
Practice Address - Street 1:7266 FRANKLIN AVE
Practice Address - Street 2:APT 106
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90046-3021
Practice Address - Country:US
Practice Address - Phone:530-351-1072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-19
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11970225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist