Healthcare Provider Details

I. General information

NPI: 1487587655
Provider Name (Legal Business Name): DEBBIE COSTA M.A., O.T.L.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25375 ORCHARD VILLAGE RD
SANTA CLARITA CA
91355-3000
US

IV. Provider business mailing address

23423 TRISTIN DR
SANTA CLARITA CA
91355-3039
US

V. Phone/Fax

Practice location:
  • Phone: 661-291-4000
  • Fax:
Mailing address:
  • Phone: 661-755-1414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number4627
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: