Basic Information
Provider Information
NPI: 1134257934
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARALDI
FirstName: ANN
MiddleName: MARIE
NamePrefix: MRS.
NameSuffix:  
Credential: OTRL
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3020 CHILDRENS WAY
Address2: MAIL CODE 5068
City: SAN DIEGO
State: CA
PostalCode: 921234223
CountryCode: US
TelephoneNumber: 8589665829
FaxNumber:  
Practice Location
Address1: 3020 CHILDRENS WAY
Address2: MAIL CODE 5068
City: SAN DIEGO
State: CA
PostalCode: 921234223
CountryCode: US
TelephoneNumber: 8589665829
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/01/2007
LastUpdateDate: 07/28/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/28/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225XP0200XOT6175CAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics

No ID Information.


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