Healthcare Provider Details

I. General information

NPI: 1184888331
Provider Name (Legal Business Name): DAISY CHEN MA, OTR/L, SWC, CLEC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2008
Last Update Date: 10/06/2021
Certification Date: 10/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

449 N CATALINA AVE APT 203
PASADENA CA
91106-1047
US

IV. Provider business mailing address

449 N CATALINA AVE APT 203
PASADENA CA
91106-1047
US

V. Phone/Fax

Practice location:
  • Phone: 626-627-0560
  • Fax:
Mailing address:
  • Phone: 626-627-0560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XF0002X
TaxonomyFeeding, Eating & Swallowing Occupational Therapist
License NumberOT 7149
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225XL0004X
TaxonomyLow Vision Occupational Therapist
License NumberOT 7149
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT 7149
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: