Healthcare Provider Details

I. General information

NPI: 1346177516
Provider Name (Legal Business Name): ALLYSON BROOKE CONTRERAS COTA/L, B.S, CLT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21551 BROOKHURST ST
HUNTINGTON BEACH CA
92646-8007
US

IV. Provider business mailing address

2543 N CUNNINGHAM CT
ORANGE CA
92867-2067
US

V. Phone/Fax

Practice location:
  • Phone: 714-293-2316
  • Fax:
Mailing address:
  • Phone: 714-293-2316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number6585
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: