Provider Demographics
NPI:1770886665
Name:YOGORE, TRINA MORENO (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:TRINA
Middle Name:MORENO
Last Name:YOGORE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MRS
Other - First Name:TRINA
Other - Middle Name:
Other - Last Name:MORENO-YOGORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:11435 MONOGRAM AVE
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-3767
Mailing Address - Country:US
Mailing Address - Phone:818-730-4134
Mailing Address - Fax:
Practice Address - Street 1:17650 DEVONSHIRE ST
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-1445
Practice Address - Country:US
Practice Address - Phone:818-886-1616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-14
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 66225XG0600X, 225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
No225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology