Provider Demographics
NPI:1053533927
Name:DEQUINA, SHEILA PIA (OTR/L)
Entity type:Individual
Prefix:
First Name:SHEILA PIA
Middle Name:
Last Name:DEQUINA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:MA.SHEILA PIA
Other - Middle Name:BALALA
Other - Last Name:RUFFY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:2140 W OLYMPIC BLVD
Mailing Address - Street 2:302
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-2207
Mailing Address - Country:US
Mailing Address - Phone:213-487-7792
Mailing Address - Fax:
Practice Address - Street 1:2140 W OLYMPIC BLVD
Practice Address - Street 2:302
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-2207
Practice Address - Country:US
Practice Address - Phone:213-487-7792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012592-1225X00000X
CA10147225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist