Healthcare Provider Details

I. General information

NPI: 1689302010
Provider Name (Legal Business Name): ESTHER N CEDARBAUM MSOT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. ESTHER LAVI

II. Dates (important events)

Enumeration Date: 08/12/2022
Last Update Date: 01/15/2024
Certification Date: 01/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ONR REHAB AT VALLEY VISTA SENIOR LIVING 7040 VAN NUYS BLVD
VAN N UYS CA
91404
US

IV. Provider business mailing address

15134 MOORPARK ST APT 201
SHERMAN OAKS CA
91403-5414
US

V. Phone/Fax

Practice location:
  • Phone: 800-967-4667
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License Number12169
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: