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NPI 1275051856

NPI 1275051856 : MEGHAN NOVOM OTR/L : LOS ANGELES, CA

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General NPI Number Information
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    NPI Number           |    1275051856
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    Entity Type          |    Individual 
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    Provider Name        |    MEGHAN NOVOM OTR/L
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/05/2017
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    Last Update Date     |    04/29/2025
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Provider Practice Location Address
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    Address Line         |    121 S MOUNTAIN VIEW AVE 
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    City                 |    LOS ANGELES
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    State                |    CA
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    Zip                  |    90057-2311
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    Country              |    US
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    Telephone            |    213-843-5495
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2720 MARTHA AVE 
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    City                 |    TORRANCE
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    State                |    CA
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    Zip                  |    90501-4742
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    Country              |    US
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    Telephone            |    805-990-5292
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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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        |    225X00000X
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    Taxonomy Name        |    Occupational Therapist
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    License Number       |    19381
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    License Number State |    CA
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