Healthcare Provider Details

I. General information

NPI: 1992759229
Provider Name (Legal Business Name): JUDITH BROWN OTRL CHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1140 W LA VETA AVENUE SUITE 860
ORANGE CA
92868
US

IV. Provider business mailing address

1140 W LA VETA AVENUE SUITE 860
ORANGE CA
92868
US

V. Phone/Fax

Practice location:
  • Phone: 714-835-6500
  • Fax: 714-541-6105
Mailing address:
  • Phone: 714-835-6500
  • Fax: 714-541-6105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License NumberOT5067
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: