Healthcare Provider Details

I. General information

NPI: 1760308282
Provider Name (Legal Business Name): PAULETTE THERESIA O'HARA OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

429 31ST ST
HERMOSA BEACH CA
90254-2136
US

IV. Provider business mailing address

429 31ST ST
HERMOSA BEACH CA
90254-2136
US

V. Phone/Fax

Practice location:
  • Phone: 310-245-1671
  • Fax:
Mailing address:
  • Phone: 310-245-1671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XF0002X
TaxonomyFeeding, Eating & Swallowing Occupational Therapist
License Number848
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number848
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number848
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number848
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: