Healthcare Provider Details

I. General information

NPI: 1972448108
Provider Name (Legal Business Name): YUKA CATHERINE REYES OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2985 BEAR ST
COSTA MESA CA
92626-4300
US

IV. Provider business mailing address

2985 BEAR ST
COSTA MESA CA
92626-4300
US

V. Phone/Fax

Practice location:
  • Phone: 310-702-8812
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number16460
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: