Healthcare Provider Details

I. General information

NPI: 1730393497
Provider Name (Legal Business Name): MOJCA C HERMAN MA, OTR/L, CHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 04/08/2020
Certification Date: 04/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 S IRENA AVE
REDONDO BEACH CA
90277-5104
US

IV. Provider business mailing address

1450 S IRENA AVE
REDONDO BEACH CA
90277-5104
US

V. Phone/Fax

Practice location:
  • Phone: 310-698-2008
  • Fax: 310-388-6416
Mailing address:
  • Phone: 424-218-9959
  • Fax: 310-388-6416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XE1200X
TaxonomyErgonomics Occupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: