Healthcare Provider Details

I. General information

NPI: 1174402663
Provider Name (Legal Business Name): SAVANNAH ALEXIA LONGORIA OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2025
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 GARDEN RD STE 200
MONTEREY CA
93940-5334
US

IV. Provider business mailing address

12 RIKER CIR
SALINAS CA
93901-2114
US

V. Phone/Fax

Practice location:
  • Phone: 831-250-6770
  • Fax:
Mailing address:
  • Phone: 831-595-2417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number28136
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: