Healthcare Provider Details

I. General information

NPI: 1477759249
Provider Name (Legal Business Name): MARTHA MAY PAJEVSKI OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARTY PAJEVSKI OTR/L

II. Dates (important events)

Enumeration Date: 06/26/2007
Last Update Date: 03/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 CHESTNUT AVE. SANTA ANA SCHOOL DISTRICT
SANTA ANA CA
92701-6322
US

IV. Provider business mailing address

9 LACRUE AVENUE, SUITE 210 EBS HEALTHCARE
CONCORDVILLE PA
19331
US

V. Phone/Fax

Practice location:
  • Phone: 714-558-5501
  • Fax:
Mailing address:
  • Phone: 800-578-7906
  • Fax: 866-295-5478

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number9791
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: