Provider Demographics
NPI:1609590165
Name:TARANTUS, SHERRI (COTA/L)
Entity type:Individual
Prefix:
First Name:SHERRI
Middle Name:
Last Name:TARANTUS
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5931 RESEDA BLVD APT 104
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-1522
Mailing Address - Country:US
Mailing Address - Phone:253-259-9947
Mailing Address - Fax:
Practice Address - Street 1:5931 RESEDA BLVD APT 104
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-1522
Practice Address - Country:US
Practice Address - Phone:253-259-9947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-28
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5977224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant