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General NPI Number Information
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NPI Number | 1104526961
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Entity Type | Organization
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Legal Business Name | KRISTY YAYA, OTR/L PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 03/08/2023
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Last Update Date | 12/19/2024
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Provider Practice Location Address
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Address Line | 2900 MADISON AVE UNIT D32
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City | FULLERTON
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State | CA
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Zip | 92831-2297
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Country | US
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Telephone | 920-639-8479
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Fax |
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Provider Business Mailing Address
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Address Line | 2900 MADISON AVE UNIT D32
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City | FULLERTON
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State | CA
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Zip | 92831-2297
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Country | US
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Telephone | 920-639-8479
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KRISTY YAYA
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Credential | OTR/L
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Telephone | 920-639-8479
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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