IndividualActive
Andrea Bullock
NPI 1871297564 · Recreation Therapist · Norwalk, CA
Provider details
- NPI number
- 1871297564
- Entity type
- Individual
- Primary specialty
- Recreation TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- 5303-T (CA)
Practice location
12636 Bloomfield Ave Apt 51
Norwalk, CA 90650-1411
Phone: (310) 228-7577
Mailing address
14445 Olive View Dr # 1d120
Sylmar, CA 91342-1437
Registry dates
- Enumerated
- 2023-03-28
- Last updated
- 2023-03-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.