Provider Demographics
NPI:1245314038
Name:VILLARAMA, JOSEPHINE (OT)
Entity type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:
Last Name:VILLARAMA
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:
Other - Last Name:VILLARAMA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OT
Mailing Address - Street 1:3320 PRIMAVERA ST
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-2028
Mailing Address - Country:US
Mailing Address - Phone:626-564-9593
Mailing Address - Fax:
Practice Address - Street 1:301 W HUNTINGTON DR
Practice Address - Street 2:SUITE 618
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-3462
Practice Address - Country:US
Practice Address - Phone:626-821-6928
Practice Address - Fax:626-821-2313
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4784225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist