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General NPI Number Information
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NPI Number | 1174159479
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Entity Type | Organization
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Legal Business Name | OMNI THERAPY, INC.
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Dates
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Enumeration Date | 03/18/2020
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Last Update Date | 07/30/2021
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Provider Practice Location Address
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Address Line | 15643 WOODFIELD PL
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-4236
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Country | US
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Telephone | 310-713-2690
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Fax |
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Provider Business Mailing Address
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Address Line | 2130 SAWTELLE BLVD STE 300
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City | LOS ANGELES
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State | CA
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Zip | 90025-6266
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHEILA SCOVILLE
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Credential |
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Telephone | 424-248-3670
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #3
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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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Taxonomy #4
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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