Healthcare Provider Details

I. General information

NPI: 1376451658
Provider Name (Legal Business Name): CHEALSY ALLISON FALLGREN OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 W WASHINGTON BLVD
CRESCENT CITY CA
95531-8340
US

IV. Provider business mailing address

301 W WASHINGTON BLVD
CRESCENT CITY CA
95531-8340
US

V. Phone/Fax

Practice location:
  • Phone: 707-464-6141
  • Fax: 707-464-0238
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT29422
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: