Provider Demographics
NPI:1124753512
Name:GIANNOPOULOS, MARIA IOANNIS (COTA/L, BS)
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:IOANNIS
Last Name:GIANNOPOULOS
Suffix:
Gender:F
Credentials:COTA/L, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2368 CORTE VIEJO UNIT 69
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91914-5001
Mailing Address - Country:US
Mailing Address - Phone:773-875-7026
Mailing Address - Fax:
Practice Address - Street 1:15632 POMERADO RD
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-2406
Practice Address - Country:US
Practice Address - Phone:858-485-5153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-19
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5271224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant