Healthcare Provider Details
I. General information
NPI: 1386883510
Provider Name (Legal Business Name): HEAD TO TOE THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/11/2009
Last Update Date: 01/16/2025
Certification Date: 08/26/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1600 E. 4TH STREET SUITE 200
SANTA ANA CA
92701-5193
US
IV. Provider business mailing address
1600 E. 4TH STREET SUITE 200
SANTA ANA CA
92701-5193
US
V. Phone/Fax
- Phone: 714-656-2371
- Fax: 949-608-1549
- Phone: 714-656-2371
- Fax: 949-608-1549
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2251P0200X |
| Taxonomy | Pediatric Physical Therapist |
| License Number | PT29111 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225XP0200X |
| Taxonomy | Pediatric Occupational Therapist |
| License Number | OT2654 |
| License Number State | CA |
VIII. Authorized Official
Name: MRS.
IRENE
WINKLER
Title or Position: CEO
Credential: OTR/L
Phone: 714-654-9328