Healthcare Provider Details

I. General information

NPI: 1356228282
Provider Name (Legal Business Name): THE SENSORY BRAIN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2025
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2810 E DEL MAR BLVD STE 2
PASADENA CA
91107-4322
US

IV. Provider business mailing address

341 MOUNT WASHINGTON DR
LOS ANGELES CA
90065-3148
US

V. Phone/Fax

Practice location:
  • Phone: 626-639-8624
  • Fax:
Mailing address:
  • Phone: 562-310-1840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225XM0800X
TaxonomyMental Health Occupational Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. JUSTINE ANN DAVID
Title or Position: CEO, OWNER
Credential: OTR/L
Phone: 562-310-1840