Healthcare Provider Details

I. General information

NPI: 1841626702
Provider Name (Legal Business Name): NANCY BERARD-SHUMAN OTR/L, CHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2013
Last Update Date: 03/16/2021
Certification Date: 03/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 N BROADWAY SUITE 860
SANTA ANA CA
92706
US

IV. Provider business mailing address

1600 N BROADWAY SUITE 860
SANTA ANA CA
92706
US

V. Phone/Fax

Practice location:
  • Phone: 714-831-5599
  • Fax: 714-783-3318
Mailing address:
  • Phone: 714-831-5599
  • Fax: 714-783-3318

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number201605068
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number3701
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: