Healthcare Provider Details

I. General information

NPI: 1992315162
Provider Name (Legal Business Name): ALEXIS NICOLE NADLER OTR-L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2020
Last Update Date: 05/30/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 N JACKSON AVE APT 123
SAN JOSE CA
95116-1907
US

IV. Provider business mailing address

180 N JACKSON AVE
SAN JOSE CA
95116-1907
US

V. Phone/Fax

Practice location:
  • Phone: 818-600-8758
  • Fax:
Mailing address:
  • Phone: 818-600-8758
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number27641
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: