Provider Demographics
NPI:1396050522
Name:DE LA TORRE, ADRIANA (OTR/L)
Entity type:Individual
Prefix:
First Name:ADRIANA
Middle Name:
Last Name:DE LA TORRE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11125 OXNARD ST
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-4931
Mailing Address - Country:US
Mailing Address - Phone:818-795-3816
Mailing Address - Fax:
Practice Address - Street 1:11125 OXNARD ST
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-4931
Practice Address - Country:US
Practice Address - Phone:818-795-3816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-12
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 10360225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist