Provider Demographics
NPI:1841480142
Name:PANGILINAN, ANTOINETTE LIMOS (MS OTR)
Entity type:Individual
Prefix:MRS
First Name:ANTOINETTE
Middle Name:LIMOS
Last Name:PANGILINAN
Suffix:
Gender:F
Credentials:MS OTR
Other - Prefix:MRS
Other - First Name:ANTOINETTE
Other - Middle Name:
Other - Last Name:LIMOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS OTR
Mailing Address - Street 1:5341 CERRO SUR ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94803-4166
Mailing Address - Country:US
Mailing Address - Phone:510-734-7700
Mailing Address - Fax:
Practice Address - Street 1:180 GRAND AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612
Practice Address - Country:US
Practice Address - Phone:510-835-2132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIOT - 598225XP0200X
CAOT 10301225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics