Provider Demographics
NPI:1194907139
Name:ROMAS, MALAMO (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:MALAMO
Middle Name:
Last Name:ROMAS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:MALAMO
Other - Middle Name:
Other - Last Name:DOUVEAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:1301 E BIDWELL ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-3452
Mailing Address - Country:US
Mailing Address - Phone:916-983-5915
Mailing Address - Fax:916-983-5925
Practice Address - Street 1:10410 COLOMA RD
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670-2108
Practice Address - Country:US
Practice Address - Phone:916-363-4843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-01
Last Update Date:2007-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5711225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist