Most Relevant Information
Provider Data
| NPI Number: | 1003587304 |
| Provider Name: | JACKLYN DE LA CRUZ OTR/L |
| Entity Type: | Individual |
| Taxonomy Code: | 224ZL0004X |
| Specialty: | Occupational Therapy Assistant |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/26/2021 |
| Last Updated: | 09/27/2021 |
Provider Practice Location
9025 COLORADO AVE
RIVERSIDE
CA
925032157
Practice Location Phone/Fax
| Phone: | 9516883636 |
| Fax: |
Provider Mailing Location
4195 CHINO HILLS PKWY # 421
CHINO HILLS
CA
917092618
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |