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General NPI Number Information
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NPI Number | 1144610635
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Entity Type | Organization
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Legal Business Name | BE WELL OCCUPATIONAL THERAPY A PROFESSIONAL CORP
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Dates
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Enumeration Date | 02/04/2015
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Last Update Date | 02/04/2015
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Provider Practice Location Address
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Address Line | 1329 E THOUSAND OAKS BLVD SUITE 128
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City | THOUSAND OAKS
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State | CA
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Zip | 91362-2824
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Country | US
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Telephone | 805-494-8430
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Fax | 805-494-8385
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Provider Business Mailing Address
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Address Line | 1329 E THOUSAND OAKS BLVD SUITE 128
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City | THOUSAND OAKS
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State | CA
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Zip | 91362-2824
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Country | US
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Telephone | 805-494-8430
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Fax | 805-494-8385
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Authorized Official
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Title or Position | PRESIDENT
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Name | ELISE LEIZEROVICH
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Credential | OTRL
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Telephone | 805-558-9898
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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 | OT14800
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License Number State | CA
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