Healthcare Provider Details

I. General information

NPI: 1679793574
Provider Name (Legal Business Name): MARTHA H PATERSON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 09/13/2024
Certification Date: 09/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 W MAGNOLIA BLVD STE 295
BURBANK CA
91506-1753
US

IV. Provider business mailing address

3727 W MAGNOLIA BLVD SUITE 710
BURBANK CA
91505-2818
US

V. Phone/Fax

Practice location:
  • Phone: 818-955-8303
  • Fax: 818-465-4606
Mailing address:
  • Phone: 818-955-8303
  • Fax: 818-558-1487

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number91-6242
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225XE1200X
TaxonomyErgonomics Occupational Therapist
License Number91-6242
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number91-6242
License Number StateCA

VIII. Authorized Official

Name: MS. MARTHA PATERSON
Title or Position: OWNER
Credential: OTR CHT
Phone: 818-955-8303