Basic Information
| Provider Information | |||||||||
| NPI: | 1699380964 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TAFFOYA | ||||||||
| FirstName: | MARIA | ||||||||
| MiddleName: | DEL REFUGIO | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | COTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1066 RAYMOND ST | ||||||||
| Address2: | |||||||||
| City: | UPLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917866827 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9095096001 | ||||||||
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| Practice Location | |||||||||
| Address1: | 800 E 5TH ST | ||||||||
| Address2: | |||||||||
| City: | ONTARIO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917642432 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9099848629 | ||||||||
| FaxNumber: | 8886198383 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2020 | ||||||||
| LastUpdateDate: | 09/13/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/13/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 224Z00000X | 1596 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant |
No ID Information.