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General NPI Number Information
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NPI Number | 1801704101
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Entity Type | Individual
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Provider Name | CLARISSA REYNOLDS OTD, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 08/29/2026
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Last Update Date | 08/29/2026
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Provider Practice Location Address
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Address Line | 233 ORANGEFAIR MALL
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City | FULLERTON
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State | CA
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Zip | 92832-3038
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Country | US
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Telephone | 714-870-6116
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Fax |
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Provider Business Mailing Address
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Address Line | 16425 ANDIRON DR
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City | WHITTIER
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State | CA
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Zip | 90604-4023
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Country | US
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Telephone | 562-309-1804
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 29548
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License Number State | CA
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