Healthcare Provider Details

I. General information

NPI: 1497689814
Provider Name (Legal Business Name): ANN ABEL OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 HUGHES WAY
LONG BEACH CA
90810-1865
US

IV. Provider business mailing address

16311 SUMMERSHADE DR
LA MIRADA CA
90638-2742
US

V. Phone/Fax

Practice location:
  • Phone: 562-997-8000
  • Fax:
Mailing address:
  • Phone: 562-997-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number6219
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: