Provider Demographics
NPI:1932795127
Name:DEGRATE, ALEXIS CAPRI (OTR)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:CAPRI
Last Name:DEGRATE
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 1:9244 RAMONA ST UNIT 6
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-6480
Mailing Address - Country:US
Mailing Address - Phone:310-387-5767
Mailing Address - Fax:
Practice Address - Street 1:9244 RAMONA ST UNIT 6
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-6480
Practice Address - Country:US
Practice Address - Phone:310-387-5767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-12
Last Update Date:2020-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21492225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty