Provider Demographics
NPI:1841462736
Name:NAZARINO, AVA MAGDALENA (OTR/L)
Entity type:Individual
Prefix:MS
First Name:AVA
Middle Name:MAGDALENA
Last Name:NAZARINO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6750 HAWAII KAI DR APT 207
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96825-1521
Mailing Address - Country:US
Mailing Address - Phone:808-260-3886
Mailing Address - Fax:
Practice Address - Street 1:98-1247 KAAHUMANU ST # 117A
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-5311
Practice Address - Country:US
Practice Address - Phone:808-260-3886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-31
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6706225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist