Individual provider · NPI-1

Johanna Ballesteros, OTR/L

Occupational Therapist · Torrance, CA

NPI number1619450673
StatusActive
Last updated in NPPESSep 14, 2018

Details

NPI
1619450673
Entity type
Individual (NPI-1)
Name
Johanna Ballesteros
Credential
OTR/L
Sex
Female
Sole proprietor
Yes
Enumeration date
Sep 14, 2018
Last updated
Sep 14, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225X00000X Occupational TherapistOT12297CAYes

Practice location

1621 W 220th St
Torrance, CA 90501-3841

Phone 727-455-2562

Mailing address

1621 W 220th St
Torrance, CA 90501-3841

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