Provider Demographics
NPI:1700512555
Name:NORIMOTO, PEARL GILLIAN AQUINO (OT)
Entity type:Individual
Prefix:
First Name:PEARL GILLIAN
Middle Name:AQUINO
Last Name:NORIMOTO
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:PEARL
Other - Middle Name:GILLIAN
Other - Last Name:AQUINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 31396
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-8396
Mailing Address - Country:US
Mailing Address - Phone:259-939-8585
Mailing Address - Fax:
Practice Address - Street 1:2625 SHADELANDS DR
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2512
Practice Address - Country:US
Practice Address - Phone:925-939-8585
Practice Address - Fax:925-933-2709
Is Sole Proprietor?:No
Enumeration Date:2022-07-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20165225X00000X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist