Healthcare Provider Details

I. General information

NPI: 1851295513
Provider Name (Legal Business Name): THE CAPABLE COAST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

804 HILLCREST ST
EL SEGUNDO CA
90245-2024
US

IV. Provider business mailing address

214 MAIN STREET #469
EL SEGUNDO CA
90245
US

V. Phone/Fax

Practice location:
  • Phone: 203-856-0522
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: ROXANNE CHESS PIERSON
Title or Position: MANAGER AND OCCUPATIONAL THERAPIST
Credential: OTR/L
Phone: 203-856-0522