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General NPI Number Information
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NPI Number | 1326167701
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Entity Type | Individual
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Provider Name | LAURA STUTZ ESTANISLAU OTR/L
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Gender | Female
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 04/17/2013
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Provider Practice Location Address
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Address Line | 16052 BEACH BLVD SUITE 135
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-3801
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Country | US
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Telephone | 949-533-1141
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Fax |
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Provider Business Mailing Address
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Address Line | 5742 FURNACE CREEK RD
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City | YORBA LINDA
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State | CA
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Zip | 92886-6020
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Country | US
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Telephone | 949-533-1141
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT 2878
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License Number State | CA
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