Provider Demographics
NPI:1841677721
Name:THE CENTER FOR THE PARTIALLY SIGHTED
Entity type:Organization
Organization Name:THE CENTER FOR THE PARTIALLY SIGHTED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NEKOLE
Authorized Official - Middle Name:AMBER
Authorized Official - Last Name:EATON
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:805-407-5395
Mailing Address - Street 1:6101 W CENTINELA AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-6351
Mailing Address - Country:US
Mailing Address - Phone:310-988-1970
Mailing Address - Fax:310-988-1980
Practice Address - Street 1:6101 W CENTINELA AVE STE 150
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-6351
Practice Address - Country:US
Practice Address - Phone:310-988-1970
Practice Address - Fax:310-988-1980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-30
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14458261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center