Provider Demographics
NPI:1871789966
Name:ESPANTO, SERGIO (OTR/L, CHT)
Entity type:Individual
Prefix:MR
First Name:SERGIO
Middle Name:
Last Name:ESPANTO
Suffix:
Gender:M
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:657 E MENDOCINO ST
Mailing Address - Street 2:
Mailing Address - City:ALTADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91001-2336
Mailing Address - Country:US
Mailing Address - Phone:323-828-7718
Mailing Address - Fax:626-798-4743
Practice Address - Street 1:657 E MENDOCINO ST
Practice Address - Street 2:
Practice Address - City:ALTADENA
Practice Address - State:CA
Practice Address - Zip Code:91001-2336
Practice Address - Country:US
Practice Address - Phone:323-828-7718
Practice Address - Fax:626-798-4743
Is Sole Proprietor?:No
Enumeration Date:2007-09-21
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 3730225XE1200X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225XE1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistErgonomics