Basic Information
| Provider Information | |||||||||
| NPI: | 1265630966 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GALEANO | ||||||||
| FirstName: | NANCI | ||||||||
| MiddleName: | RAQUEL | ||||||||
| NamePrefix: | MISS | ||||||||
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| Credential: | OTR | ||||||||
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| Mailing Information | |||||||||
| Address1: | 30527 VIA PARED | ||||||||
| Address2: | |||||||||
| City: | THOUSAND PALMS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92276 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7603430268 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 72-201 COUNTRY CLUB DRIVE | ||||||||
| Address2: | |||||||||
| City: | RANCHO MIRAGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92270 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7603405999 | ||||||||
| FaxNumber: | 7603419972 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | OT 7223 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.