Healthcare Provider Details

I. General information

NPI: 1023953130
Provider Name (Legal Business Name): EMILY STIEGLITZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 MOLINO AVE
LONG BEACH CA
90804-3608
US

IV. Provider business mailing address

1000 MOLINO AVE
LONG BEACH CA
90804-3608
US

V. Phone/Fax

Practice location:
  • Phone: 773-619-5339
  • Fax:
Mailing address:
  • Phone: 773-619-5339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number8629
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: