Provider Demographics
NPI:1366927592
Name:RAPAZZO, SUMMER (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:SUMMER
Middle Name:
Last Name:RAPAZZO
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7990 AMADOR AVE
Mailing Address - Street 2:
Mailing Address - City:YUCCA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92284-4073
Mailing Address - Country:US
Mailing Address - Phone:760-821-3994
Mailing Address - Fax:
Practice Address - Street 1:77564 COUNTRY CLUB DR STE 340
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92211-0450
Practice Address - Country:US
Practice Address - Phone:760-772-2838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-03
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4476224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant