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General NPI Number Information
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NPI Number | 1730045725
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Entity Type | Individual
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Provider Name | LAUREN ATHA OTR/L
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Gender | Female
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Dates
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Enumeration Date | 01/02/2026
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Last Update Date | 01/02/2026
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Provider Practice Location Address
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Address Line | 4445 MAGNOLIA AVE
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City | RIVERSIDE
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State | CA
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Zip | 92501-4135
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Country | US
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Telephone | 951-788-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 1800 WALLACE AVE APT E
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City | COSTA MESA
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State | CA
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Zip | 92627-3512
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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 |
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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 | 25490
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License Number State | CA
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