Healthcare Provider Details

I. General information

NPI: 1598692733
Provider Name (Legal Business Name): ERIN ROBERTS OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

681 LILAC DR
LOS OSOS CA
93402-3821
US

IV. Provider business mailing address

681 LILAC DR
LOS OSOS CA
93402-3821
US

V. Phone/Fax

Practice location:
  • Phone: 913-850-1261
  • Fax:
Mailing address:
  • Phone: 913-850-1261
  • Fax: 913-850-1261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number17702
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: