Healthcare Provider Details
I. General information
NPI: 1467361527
Provider Name (Legal Business Name): PEDIATRIC OCCUPATIONAL THERAPY BY THE SEA PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
256 N COAST HIGHWAY 101 STE C
ENCINITAS CA
92024-3274
US
IV. Provider business mailing address
170 PHOEBE ST APT 1
ENCINITAS CA
92024-1465
US
V. Phone/Fax
- Phone: 310-561-5173
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225XP0200X |
| Taxonomy | Pediatric Occupational Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LAURA
THATCHER
Title or Position: OWNER
Credential: MOT, OTR/L
Phone: 310-561-5173