Basic Information
| Provider Information | |||||||||
| NPI: | 1700242997 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LUZ | ||||||||
| FirstName: | RILEY | ||||||||
| MiddleName: | CHRISTINE | ||||||||
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| Credential: | OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3498 GREEN VALLEY RD | ||||||||
| Address2: | |||||||||
| City: | RESCUE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956729625 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5303918670 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3498 GREEN VALLEY RD | ||||||||
| Address2: | |||||||||
| City: | RESCUE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956729625 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5303918670 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/05/2016 | ||||||||
| LastUpdateDate: | 01/05/2016 | ||||||||
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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 | 225XP0200X | 15706 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics |
No ID Information.