Healthcare Provider Details

I. General information

NPI: 1821988726
Provider Name (Legal Business Name): NANCY BALDWIN OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2025
Last Update Date: 07/03/2025
Certification Date: 07/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30141 ANTELOPE RD STE A
MENIFEE CA
92584-8066
US

IV. Provider business mailing address

1650 LYNDON FARM CT STE 300
LOUISVILLE KY
40223-5005
US

V. Phone/Fax

Practice location:
  • Phone: 951-723-8100
  • Fax: 951-723-9101
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number27772
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: