Healthcare Provider Details

I. General information

NPI: 1003637984
Provider Name (Legal Business Name): NATASHA TRISHA NAVI OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2024
Last Update Date: 10/23/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10790 WILSHIRE BLVD APT 1004
LOS ANGELES CA
90024-4478
US

IV. Provider business mailing address

PO BOX 14655
VAN NUYS CA
91409-4655
US

V. Phone/Fax

Practice location:
  • Phone: 310-880-5530
  • Fax:
Mailing address:
  • Phone: 310-880-5530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number411538
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: