Healthcare Provider Details

I. General information

NPI: 1740104553
Provider Name (Legal Business Name): BROOKE PORTER OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 S MAIN ST
SALINAS CA
93901-2403
US

IV. Provider business mailing address

12523 ANTONIO PL
SALINAS CA
93908-8955
US

V. Phone/Fax

Practice location:
  • Phone: 831-753-5600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number27672
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: