Basic Information
| Provider Information | |||||||||
| NPI: | 1124753512 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GIANNOPOULOS | ||||||||
| FirstName: | MARIA | ||||||||
| MiddleName: | IOANNIS | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | COTA/L, B.S | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2368 CORTE VIEJO UNIT 69 | ||||||||
| Address2: | |||||||||
| City: | CHULA VISTA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 919145001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7738757026 | ||||||||
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| Practice Location | |||||||||
| Address1: | 15632 POMERADO RD | ||||||||
| Address2: | |||||||||
| City: | POWAY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920642406 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8584855153 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2022 | ||||||||
| LastUpdateDate: | 07/19/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/19/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 224Z00000X | 5271 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant |
No ID Information.