Healthcare Provider Details

I. General information

NPI: 1871791871
Provider Name (Legal Business Name): ASSOCIATED OCCUPATIONAL THERAPISTS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2007
Last Update Date: 01/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S KRAEMER BLVD STE 206
PLACENTIA CA
92870-6110
US

IV. Provider business mailing address

101 S KRAEMER BLVD STE 206
PLACENTIA CA
92870-6110
US

V. Phone/Fax

Practice location:
  • Phone: 714-961-8288
  • Fax:
Mailing address:
  • Phone: 714-961-8288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number982538
License Number StateCA

VIII. Authorized Official

Name: MR. JAY WALLACE YAEGER
Title or Position: COTA
Credential: COTA
Phone: 714-961-8288