Healthcare Provider Details

I. General information

NPI: 1578474367
Provider Name (Legal Business Name): SAUL ABAREA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13075 BLACKBIRD ST
GARDEN GROVE CA
92843-2902
US

IV. Provider business mailing address

10110 ZUNI PASS
RIVERSIDE CA
92503-5454
US

V. Phone/Fax

Practice location:
  • Phone: 714-530-6322
  • Fax:
Mailing address:
  • Phone: 714-423-8558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number5005
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: