Healthcare Provider Details

I. General information

NPI: 1558847855
Provider Name (Legal Business Name): ANNIE W CHEN OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2018
Last Update Date: 03/03/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 S BEAUDRY AVE FL 17
LOS ANGELES CA
90017-5105
US

IV. Provider business mailing address

333 S BEAUDRY AVE FL 17
LOS ANGELES CA
90017-5105
US

V. Phone/Fax

Practice location:
  • Phone: 213-241-6200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number17946
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: