Healthcare Provider Details

I. General information

NPI: 1407783178
Provider Name (Legal Business Name): MRS. KAREN REZA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 N HANDY ST
ORANGE CA
92867-4434
US

IV. Provider business mailing address

803 E WALNUT AVE
ORANGE CA
92867-6835
US

V. Phone/Fax

Practice location:
  • Phone: 714-628-4000
  • Fax:
Mailing address:
  • Phone: 714-306-9409
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number2120
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2120
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: