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General NPI Number Information
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NPI Number | 1710471602
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Entity Type | Individual
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Provider Name | DEMI NELSON MS, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 06/14/2018
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Last Update Date | 08/16/2022
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Provider Practice Location Address
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Address Line | 5423 TURNER CT
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City | LAKEWOOD
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State | CA
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Zip | 90712-1451
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Country | US
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Telephone | 562-714-6728
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Fax |
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Provider Business Mailing Address
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Address Line | 765 STONE HARBOR CIR
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City | LA HABRA
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State | CA
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Zip | 90631-8935
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Country | US
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Telephone | 562-714-6728
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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 | 17814
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License Number State | CA
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