Healthcare Provider Details

I. General information

NPI: 1508174574
Provider Name (Legal Business Name): THERAPY DYNAMICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2010
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8811 GARVEY AVE STE 203
ROSEMEAD CA
91770-2464
US

IV. Provider business mailing address

7220 ELDERLY AVE
LAS VEGAS NV
89131-3220
US

V. Phone/Fax

Practice location:
  • Phone: 626-943-9153
  • Fax: 626-943-9216
Mailing address:
  • Phone: 626-943-9153
  • Fax: 626-943-9216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code225XL0004X
TaxonomyLow Vision Occupational Therapist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License NumberOT7380
License Number StateCA

VIII. Authorized Official

Name: CARLA D VARELA
Title or Position: CEO/CFO
Credential: OTR, HTC
Phone: 626-943-9153