Healthcare Provider Details

I. General information

NPI: 1306739347
Provider Name (Legal Business Name): CHELSY DANA ESQUBEL COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHELSY DANA EGAN COTA/L

II. Dates (important events)

Enumeration Date: 05/29/2025
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4315 E WEHRLE CT
LONG BEACH CA
90804-3031
US

IV. Provider business mailing address

4315 E WEHRLE CT
LONG BEACH CA
90804-3031
US

V. Phone/Fax

Practice location:
  • Phone: 714-397-6473
  • Fax:
Mailing address:
  • Phone: 714-397-6473
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number4114
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: