Healthcare Provider Details

I. General information

NPI: 1740064161
Provider Name (Legal Business Name): NADEEN ELHAJJAOUI OTD, OTR/L, CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2023
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9900 INDIANA AVE STE 8
RIVERSIDE CA
92503-5498
US

IV. Provider business mailing address

670 STONELEIGH AVE STE 202
CARMEL NY
10512-3997
US

V. Phone/Fax

Practice location:
  • Phone: 951-376-1120
  • Fax: 951-376-1182
Mailing address:
  • Phone: 845-279-5711
  • Fax: 845-230-4795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number25369
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number029576
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: