Provider Demographics
NPI:1194807776
Name:ARGUELLES, MARIVIC (OCCUPATIONAL THERAPY)
Entity type:Individual
Prefix:
First Name:MARIVIC
Middle Name:
Last Name:ARGUELLES
Suffix:
Gender:F
Credentials:OCCUPATIONAL THERAPY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1455 BALHAN DR APT 101
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94521-3757
Mailing Address - Country:US
Mailing Address - Phone:925-323-7530
Mailing Address - Fax:
Practice Address - Street 1:4560 SE INTERNATIONAL WAY
Practice Address - Street 2:CONSONUS REHAB SERVICES
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222
Practice Address - Country:US
Practice Address - Phone:971-206-5140
Practice Address - Fax:971-206-5209
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2017-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 7296225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist