Healthcare Provider Details

I. General information

NPI: 1235397563
Provider Name (Legal Business Name): YUKO OHSHITA MA, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2008
Last Update Date: 11/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14112 S KINGSLEY DR
GARDENA CA
90249-3018
US

IV. Provider business mailing address

11080 W OLYMPIC BLVD
LOS ANGELES CA
90064-1937
US

V. Phone/Fax

Practice location:
  • Phone: 310-217-7312
  • Fax:
Mailing address:
  • Phone: 310-482-3206
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XM0800X
TaxonomyMental Health Occupational Therapist
License NumberOT10371
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: