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NPI Code Detail

MEDICARE: MS. MARY THERESA PORCELLA OTR/L

MEDICARE: MS. MARY THERESA PORCELLA OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist5321CA

General Provider Information

NPI Number : 1255662367
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARY THERESA PORCELLA OTR/L
Provider Business Mailing Address
First Line : 1401 N HANDY ST
Second Line :
City : ORANGE
State : CA
Zip : 92867-4434
Country : US
Telephone Number : 714-628-4080
Fax Number :
Provider Business Practice Location Address
First Line : 1401 N HANDY ST
Second Line :
City : ORANGE
State : CA
Zip : 92867-4434
Country : US
Telephone Number : 714-628-4080
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2010
Last Update Date : 06/18/2026

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Directions to “ MS. MARY THERESA PORCELLA OTR/L” Practice Location

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