Healthcare Provider Details

I. General information

NPI: 1992632491
Provider Name (Legal Business Name): HANNAH PARK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 GRAHAM LN
SANTA ANA CA
92703-4726
US

IV. Provider business mailing address

1601 E CHESTNUT AVE
SANTA ANA CA
92701-6322
US

V. Phone/Fax

Practice location:
  • Phone: 714-972-6000
  • Fax: 714-972-6099
Mailing address:
  • Phone: 714-972-6000
  • Fax: 714-972-6099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: