Healthcare Provider Details

I. General information

NPI: 1043419476
Provider Name (Legal Business Name): LYNN SUE QUAN OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2007
Last Update Date: 09/25/2024
Certification Date: 09/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9320 TELSTAR AVE STE. 226
EL MONTE CA
91731-2816
US

IV. Provider business mailing address

9235 KENNERLY ST
TEMPLE CITY CA
91780-3728
US

V. Phone/Fax

Practice location:
  • Phone: 626-293-7553
  • Fax:
Mailing address:
  • Phone: 323-401-5744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT2335
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License NumberOT 2335
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: