Healthcare Provider Details

I. General information

NPI: 1902153448
Provider Name (Legal Business Name): ROBYN YONEDA OGAWA OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ROBYN SUZUMI YONEDA OTR/L

II. Dates (important events)

Enumeration Date: 08/14/2012
Last Update Date: 08/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8541 VILLAGE LN
ROSEMEAD CA
91770-4375
US

IV. Provider business mailing address

8541 VILLAGE LN
ROSEMEAD CA
91770-4375
US

V. Phone/Fax

Practice location:
  • Phone: 626-280-4695
  • Fax:
Mailing address:
  • Phone: 626-280-4695
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224ZR0403X
TaxonomyDriving and Community Mobility Occupational Therapy Assistant
License NumberOT 1585
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT 1585
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License NumberOT1585
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: