Healthcare Provider Details

I. General information

NPI: 1427843689
Provider Name (Legal Business Name): THERAPY PLACE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2025
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1932 14TH ST
SANTA MONICA CA
90404-4605
US

IV. Provider business mailing address

13522 FELSON ST
CERRITOS CA
90703-8913
US

V. Phone/Fax

Practice location:
  • Phone: 562-833-9110
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: SOYOUNG BAE
Title or Position: CEO
Credential: OTD, OTR/L
Phone: 562-833-9110