Healthcare Provider Details

I. General information

NPI: 1760936645
Provider Name (Legal Business Name): ANDREW NARVASA ANTONIO OTR/L, CHT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2016
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48TH MDG/RAF LAKENHEATH, APO, AE 09461
LAKENHEATH UNITED KINGDOM
09461
GB

IV. Provider business mailing address

48TH MDG/RAF LAKENHEATH, APO, AE 09461
LAKENHEATH UNITED KINGDOM
09461
GB

V. Phone/Fax

Practice location:
  • Phone: 661-878-4180
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number15424
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: