Provider Demographics
NPI:1124111042
Name:SPILLER, RAMONA ANITA (CTRS)
Entity type:Individual
Prefix:
First Name:RAMONA
Middle Name:ANITA
Last Name:SPILLER
Suffix:
Gender:F
Credentials:CTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 84149
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90073-0149
Mailing Address - Country:US
Mailing Address - Phone:310-268-3934
Mailing Address - Fax:310-268-4301
Practice Address - Street 1:11301 WILSHIRE BLVD
Practice Address - Street 2:RECREATION THERAPY SECTION (117R)
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90073-1003
Practice Address - Country:US
Practice Address - Phone:310-268-3934
Practice Address - Fax:310-268-4301
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist