Healthcare Provider Details

I. General information

NPI: 1376992347
Provider Name (Legal Business Name): GLORIA HSU OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2016
Last Update Date: 10/12/2021
Certification Date: 10/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 S YNEZ AVE APT A
MONTEREY PARK CA
91754-2841
US

IV. Provider business mailing address

121 S YNEZ AVE APT A
MONTEREY PARK CA
91754-2841
US

V. Phone/Fax

Practice location:
  • Phone: 626-230-1113
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XF0002X
TaxonomyFeeding, Eating & Swallowing Occupational Therapist
License Number11417
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number11417
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: