Provider Demographics
NPI:1144437757
Name:AFTAB, MAHJABEEN (OT)
Entity type:Individual
Prefix:MRS
First Name:MAHJABEEN
Middle Name:
Last Name:AFTAB
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23620 SUNSET CROSSING RD
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-1348
Mailing Address - Country:US
Mailing Address - Phone:909-621-0447
Mailing Address - Fax:909-621-2747
Practice Address - Street 1:224 N INDIAN HILL BLVD
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-4609
Practice Address - Country:US
Practice Address - Phone:909-621-0447
Practice Address - Fax:909-621-2747
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5552225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist