Healthcare Provider Details

I. General information

NPI: 1104595545
Provider Name (Legal Business Name): COURTNEY RAMIREZ OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2021
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 ORANGEFAIR MALL
FULLERTON CA
92832-3038
US

IV. Provider business mailing address

233 ORANGEFAIR MALL
FULLERTON CA
92832-3038
US

V. Phone/Fax

Practice location:
  • Phone: 714-870-6116
  • Fax:
Mailing address:
  • Phone: 714-870-6116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number24249
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: